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CI-SMART™ - Your Reimbursement Resource

AB developed the Cochlear Implant - Strategic Model for Advocacy and Reimbursement Training (CI-SMART) with the goal of improving access to audiology services. The model is designed to capture data on clinical and reimbursement practices in order to help identify issues and prioritize CI clinic reimbursement services.

The collected data is designed to support reimbursement training and advocacy efforts and with the goal of removing reimbursement barriers, which improves patient access to cochlear implant services.

CI-SMART Coding and Billing References

Advanced Bionics provides up-to-date coding and billing information for cochlear implant-related products and services. This reimbursement resource area helps your team find coding and billing information.

CI-SMART Benchmarks and Data

With data gathered from 40 clinics, CI-SMART provides a benchmark on CI clinical and reimbursement best practices.

The model depicts data reported by CI audiologists on the services performed, how much time was spent to deliver CI services, and how those services were billed and paid.

The CI-SMART model provides clinicians with straightforward, industry-wide data that may provide insight into their center’s reimbursement situation.

AB Helps Reduce Clinics’ Non-Billable Time

To help ensure the success of CI recipients and the clinics that support them, AB offers the following professional support services designed to benefit patients and help reduce your clinic’s non-billable time:

Bionic Ear Association

Staffed by both audiologists and recipients who provide troubleshooting, counseling, mentorship, and educational material to CI patients.

Processor DirectTM

With this program, replacement processors are sent straight to recipients, restoring their hearing more quickly and saving you time. Improves on-the-air time and reduces non-billable time to re-load and re-ship replacement processors from the clinic.

TeleCARE

Remote online professional support when the need is immediate or the clinical specialist is unable to be present at the clinic in person. Contact your Clinical Specialist to learn more about TeleCare.

Audiologist on Call (AOC)

Direct professional support and recipient troubleshooting assistance by phone. Contact Customer Service at 877-829-0026 and ask for the AOC.

Customer Service

Live phone and online chat support for orders and inquiries.

Insurance Reimbursement Services

AB’s insurance specialists expertly handle pre-authorization and appeals for cochlear implantation, replacement supplies, and equipment.

CI-SMART Webinars - Solutions for CI Centers’ Top Reimbursement Issues

The CI-SMART Webinar Series reveals reimbursement best practices along with supporting resources for today’s CI centers. AB invites surgeons, audiologists, coding and billing staff, and financial staff members at cochlear implant centers to view this free recorded series to learn key findings from the CI-SMART study that can be readily applied to their own CI centers.

CI-SMART: Understanding CI Clinic Reimbursement

View the first in this series of educational webinars to learn the key findings revealed by CI-SMART and how Advanced Bionics can help you to address those issues.

CI-SMART: Fact-Based Coding & Billing Best Practices

Learn fact-based coding and billing best practices for the Top 10 clinic scenarios identified in AB’s CI-SMART study. Please invite your coding and billing staff to view this webinar and download CI coding and payment reference documents.

CI-SMART: Benchmark Data Insights for Your CI Clinic

Find out how to access CI-SMART benchmark data to gain insights into clinical and reimbursement best practices. Please join us for this educational webinar and take advantage of the findings from the first-ever, nationwide benchmark study on CI clinical and reimbursement practices.

CI-SMART: Coding and Billing FAQ for CI Audiology

Is your center coding accurately? This webinar addresses CI audiology coding and billing FAQs.

CI-SMART: Understanding Evaluation CPT Code 92626

Do you know when to use CPT 92626? CI-SMART coding data revealed confusion about the scope of this newer, time-based CPT code which was added in 2006. This webinar focuses on clarifying the intended uses of CPT code 92626: Evaluation of auditory rehabilitation status, first hour and other audiological testing codes.

CI-SMART: Reducing Non-Billable Services

In the CI-SMART study, audiologists reported spending nearly half of their time providing non-billable services. Sign up for this session to learn about options to reduce non-billable time in order to improve patient access to CI audiology services.

CI-SMART: Good Documentation Practices for CI Audiology Reimbursement

Join this session where Bob Fifer and Terry Zwolan provide insights on good documentation practices that support CI audiology reimbursement.

CI-SMART Coding and Billing References

Advanced Bionics provides up-to-date coding and billing information for cochlear implant-related products and services. This reimbursement resource area helps your team find coding and billing information.

CI Coding Quick Reference Guides

Cochlear Implant Coding Quick Reference Guides list cochlear implant-related codes in a single easy-to-read document to help facilitate coding and billing for CI services. Review guides from current and previous years.

For Clinics: 2009 Cochlear Implant Coding Quick Reference for Clinics

For Hospitals: 2009 Cochlear Implant Coding Quick Reference for Hospitals

CI Billing and Coding FAQ

Have you ever wondered which audiology codes can be billed together and which ones can be paid separately?

Medicare National Correct Coding Initiative (CCI) Edits and Outpatient Coding Editor (OCE) Edits Overview. The CCI edits are used for processing services paid under the Medicare Physician Fee Schedule, while the OCE edits are used for processing hospital outpatient services paid under the Hospital Outpatient Prospective Payment System (OPPS).

AB compiled CCI and OCE edits for selected CI-related services into a single document along with a list of helpful references in an easy-to-read format.

Helpful web links:

Medicare National Correct Coding Initiative Home Page

CCI Edit Table

OCE Edit Table

Medicare Policies on Audiology Services

Does your center know which audiology services can be rendered by an audiologist, an SLP, or an audiology technician? Medicare released three Transmittals that clarify in detail which audiology services it covers and who can perform them. These Transmittals specifically define the benefit policy that covers audiology services and which services can be rendered by an audiologist, a speech-language pathologist (SLP), or an audiology technician, as well as provide updated claims submission instructions.

Medicare Transmittals
Transmittal 84:Update to audiology policies — Medicare Benefit Policy
Transmittal 1470: Update to audiology policies — Medicare Claims Processing Manual
Transmital 1550: Clarification to audiology update Transmittal 1470, Medicare Claims Processing Manual

Guidelines for Billing Time-Based CPT Codes

Do you need to know what guidelines exist for billing time-based Current Procedural Terminology (CPT) codes, such as 92626 and 92627?

Medicare provides guidelines for billing time-based services and many other instructions through its online manuals.

Billing Time-Based Codes (Pub. 100-04, Chapter 5, Section 20.2) Select Chapter 5 and scroll down to section 20.2 to view Medicare guidelines for billing time-based codes.

Current CPT Coding Resources

Do you need the latest information on audiology CPT codes and their use?

The American Medical Association (AMA) provides a selection of coding resources including ”the CPT book” and subscriptions to the monthly newsletter, CPT Assistant.

American Medical Association Bookstore
CPT
CPT Assistant

Fast Online RMAs

Quickly and easily replace sound processors with Processor Direct.

Learn about the Harmony System

AB offers solutions to help you reconnect to the world of sound.