Billing and Coding: Stretta Procedure

This billing and coding guidance for the Stretta procedure requires valid ICD-10-CM diagnosis codes, appropriate reporting of referring provider name/NPI, and complete signed medical records including test results. Non-covered or likely-to-be-denied services must be reported with the appropriate ABN modifier (GA, GX, GZ, or GY) with specific rules for when ABNs are required and automatic denial behavior; verify NCCI and OPPS edits and follow Part A/Part B MAC-specific billing instructions (including FQHC bill-type changes effective April 1, 2010).

"A claim submitted without a valid ICD-10-CM diagnosis code will be returned to the provider as an incomplete claim under Section 1833(e)."

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