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Mutual News June 2020 Bulletin
Medical Mutual of Ohio·OH · Orthopedics, General Surgery, Cardiothoracic Surgery +7 more·Mutual News Bulletin
Effective date
Jul 1, 2020
We identified it
Jun 20, 2026
Summary
Medical Mutual is implementing a new implants reimbursement policy effective July 1, 2020, requiring devices billed under Revenue Code 278 to meet FDA's definition of implant, including permanency of 30+ days. Devices that don't meet this definition will be denied payment.
Action Required
By July 1, 2020: Billing team must update system to only use Revenue Code 278 for devices that meet FDA implant definition (placed in surgically/naturally formed body cavity, intended to remain 30+ days or more). Review all current implant billings and recode non-permanent devices to appropriate revenue codes. Claims for non-qualifying devices under Revenue Code 278 will be denied.