Horizontal Therapy with the Hako-med Device

[Guest guest]

I have a provider that insists on doing horizontal therapy treatment

on patients using the Hako-med device. When he does this procedure,

it is coded with an unlisted procdure code 97799.

I have not received a single payment on this procedure code.

Everytime that I submit a claim with 97799, I drop it to paper and

submit the description of the Horizontal Therapy along with the

Horizontal Therapy treatment note.

I have had absolutely no luck getting reimbursement from any payer.

The denials generally state that the treatment is investigational and

that the member's policy does not cover investigational treatment. We

could bill the patient, but I don't think that this would be a wise

move. The patient could not have reasonably expected that the

treatment that they received would be considered investigational, and

this was definately not explained to the patient prior to treatment.

What are your thoughts?!?

Thanks,

Penick