Negotiated reimbursement rates for D5922 across 2 states, sourced from CMS Transparency in Coverage data. 20 rate records.
D5922 denotes a nasal septal prosthesis, which is utilized to restore the nasal septum's structure and function after surgical removal or trauma. Clinical indications include nasal deformities that affect breathing or aesthetic appearance. Documentation for billing must include a thorough clinical evaluation, imaging studies if applicable, and a clear rationale for the prosthesis. Reimbursement for D5922 can differ based on the payor and state regulations, with some plans offering better coverage for medically necessary procedures. It is crucial to confirm the specifics of coverage with the patient's insurance provider prior to proceeding with treatment.
Reimbursement rates for D5922 vary significantly by state, payor, and provider network. The national average negotiated rate is $88. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
-1+ more states available with Pro ↓
| State | Avg Rate |
|---|---|
| New York | $194 |
| Pennsylvania | $194 |
| State | Avg Rate |
|---|---|
| New York | $194 |
| Pennsylvania | $194 |