Deltex Medical's CardioQ™ esophageal Doppler monitor is a minimally invasive method to optimize fluid levels in patients in intensive care or who are undergoing surgery. Medicare and some commercial insurers provide coverage for EDM for specific patient populations.

In the absence of a specific CPT® that describes EDM services, Centers for Medicare and Medicaid Services (CMS) has issued guidance directing physicians to use an unlisted code, 76999-26, to report the professional component of the service.

Medicare payment for an unlisted code is set at the regional contractor level. Commercial payers have their own methodologies for setting payment rates for unlisted codes. Some have written policies for unlisted codes. Others refer to the negotiated rate (i.e. a percentage of charges) included in the provider contract.

Please see the links below for more information on coverage, coding and payment for EDM.

Website Disclaimer
This information is provided by Deltex Medical as a guide for coding procedures and services involving Esophageal Doppler Monitoring. It is not intended to increase or maximize reimbursement by any payer. This information is intended to assist providers in accurately obtaining coverage and reimbursement for their health care services. Deltex makes no express or implied warranty or guarantee (i) that the list of codes and narratives is complete or error-free, (ii) that the use of this information will prevent differences of opinions or disputes with payers, (iii) that these codes will be covered, or (iv) that the provider will be guaranteed reimbursement. Providers assume full responsibility for all reimbursement decisions or actions. We strongly suggest you consult your payer organizations with regard to local coverage and reimbursement policies.

© Deltex Medical | Contact Us | Terms and Conditions | Site Map