mild global

[myrandom2003]

---

Members don't see this ad.

I have a patient with 1 level severe stenosis and 2 levels mod stenosis. All injections have been done at the severe level and work great but not lasting relief.
So the global period for mILD is 90 days.
The rep is telling me that you cannot repeat mILD for one year at an adjacent level. Is that correct?
It doesn't sound right to me and I cannot find that documented anywhere.

 

[Ducttape]

yes 1 year.

i have asked for auth for repeat MILD that was 1 week short of 1 year and was denied but was approved when requested 1 week after 1 year anniversary.

 

[BoardingDoc]

How are you guys getting paid for MILD? I heard that because it's a T code it doesn't necessarily get reimbursed. I also heard that is changing in 2026 with it's own code but I'm just trying to figure this out. I'd be doing it in PP either in an ASC or in office if that's doable which some people here seem to have suggested that it is.

 

[mdo1738]

How are you guys getting paid for MILD? I heard that because it's a T code it doesn't necessarily get reimbursed. I also heard that is changing in 2026 with it's own code but I'm just trying to figure this out. I'd be doing it in PP either in an ASC or in office if that's doable which some people here seem to have suggested that it is.

Medicare guarantees reimbursement for all patients who meet the NCD. All Medicare Advantage plans are contractually obligated to do so as well. Make sure to get a note template for your clinic visit that includes all those criteria and document that the patient meets them. You will get paid.

 

[DoYouEvenLiftBro]

We also put this with our note as well, per their criteria

“This patient is a participant in clinical trial #03072927.”

https://www.vertosmed.com/wp-content/uploads/2023/01/mild-2024-Billing-Guide-1.pdf