RF Ablation

To ensure that a patient meets the medically necessary policy criteria, or to find out if prior authorization/pre-determination is required, please contact the patient's payer directly.

Coding

RF Ablation for Symptomatic Benign Prostatic Hyperplasia (BPH)
  • ICD-9- Procedure Codes
  • CPT® Procedure Codes
  • Commonly Billed CPT Codes
  • Sample Commercial Payer Rate Adjustment Letter
  • Sample Letter for Physician Office Setting
  • Sample Letter for Commercial Payer Prior Authorization

Coverage

Download sample letters to assist with prior authorization and coverage.

Use this form to submit a prior authorization request and start the prior authorization process.

Use this form to choose the level of service for prior authorizations.

This PDF includes information on how to secure prior authorization and general information on the Prostiva® RF System. You can customize the letter with the patient's treatment history and evidence supporting the necessity of RF ablation.

This customizable sample letter addresses site of service (SOS) differential issues.

This sample letter provides a template to help your office renegotiate your rate for RF ablation.

Medtronic has compiled this information for your convenience. It is always the provider's responsibility to determine coverage and submit appropriate codes, modifiers, and charges for the services that were rendered. Contact your local carrier/payer for interpretation of appropriate coverage and coding policies.

For unapproved uses, consult with your local carrier/payer before seeking reimbursement for use of a product that may be inconsistent with or not expressly specified in the FDA cleared or approved labeling (manual). Some payers may have policies that make it inappropriate to submit claims for such items or related services.