HCPCS

Inspire Medical Systems, Inc. Announces Recommendation by Medicare Panel to Increase Payments for Inspire Therapy to Ambulatory Surgical Centers

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月曜日, 8月 30, 2021
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Last year, the AMA panel created a new category I CPT code for the Inspire procedure (CPT 645X1), which will go into effect on January 1, 2022.

Key Points: 
  • Last year, the AMA panel created a new category I CPT code for the Inspire procedure (CPT 645X1), which will go into effect on January 1, 2022.
  • On the contrary, the hospital reimbursement for the new code proposed a 3% increase to just over $30,000.
  • The result of this proposed change by CMS reduced the payment for the Inspire procedure from nearly $25,000 to approximately $17,500.
  • Inspire presented historical patient data for Inspire therapy at the advisory panel meeting.

Centers for Medicare & Medicaid Services Issues New Code for Encala®

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水曜日, 8月 25, 2021
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This decision establishes the S9432 code, "Medical Food for Non-Inborn Errors of Metabolism," in response to Envara Health's initial application.

Key Points: 
  • This decision establishes the S9432 code, "Medical Food for Non-Inborn Errors of Metabolism," in response to Envara Health's initial application.
  • Coding gives patients and their families access to important new treatments," stated Katie Derks, who spoke in favor of issuing a new code during the CMS public meeting.
  • Katie added, "I'm so happy that many others will now have access to Encala."
  • The newly created HCPCS Level II code is a breakthrough towards making a novel and needed clinical nutrition solution more broadly available.

TherapeuticsMD Announces Issuance of a J-Code for ANNOVERA® to Be Utilized in the Public Health Sector

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月曜日, 8月 23, 2021
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This new J Code will allow dispensing Public Health facilities the opportunity to gain reimbursement for ANNOVERA, including the approximately 4,900 Title X Family Planning clinics.

Key Points: 
  • This new J Code will allow dispensing Public Health facilities the opportunity to gain reimbursement for ANNOVERA, including the approximately 4,900 Title X Family Planning clinics.
  • Public Health claims submission and payment are standardized with a J Code, facilitating and streamlining billing and reimbursement.
  • Public Health insured patients represent a growing segment of the ANNOVERA user base.
  • Having a permanent J Code will simplify Public Health billing and payment, further enhancing patient access to ANNOVERA in a growing segment of our user base.

Theranica Announces the Establishment of a Unique Level II HCPCS Code by the Centers for Medicare and Medicaid Services (CMS)

Retrieved on: 
月曜日, 8月 16, 2021
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Level II of the HCPCS is a standardized coding system used primarily to identify products, supplies, and services such as medical devices used outside a physician's office.

Key Points: 
  • Level II of the HCPCS is a standardized coding system used primarily to identify products, supplies, and services such as medical devices used outside a physician's office.
  • "The creation of this new HCPCS code covering Nerivioacknowledges the unique aspects of our technology and helps distinguish our device from other modalities such as TENS.
  • Theranica is a prescribed digital therapeutics company dedicated to creating effective, safe, affordable, low-side effect, therapies for idiopathic pain conditions.
  • Learn more by visiting our website, theranica.com and following us on LinkedIn , Twitter , Instagram ,and Facebook .

Oncopeptides' PEPAXTO® Receives a Permanent J-Code, Clarifying Reimbursement Processes in Hospital Outpatient and Physician Office Settings of Care

Retrieved on: 
月曜日, 8月 16, 2021
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J codes are product-specific reimbursement codes assigned to outpatient and physician administered "buy and bill" products under Medicare Part B.

Key Points: 
  • J codes are product-specific reimbursement codes assigned to outpatient and physician administered "buy and bill" products under Medicare Part B.
  • Claims submission and payment are standardized with a J-code, thereby facilitating and clarifying billing and reimbursement from Medicare, Medicaid, and commercial insurance.
  • PEPAXTO is not indicated and is not recommended for use as a conditioning regimen for transplant outside of controlled clinical trials.
  • Oncopeptides plans to submit data from the OCEAN study to the International Myeloma Workshop meeting in Vienna, Austria on September 8-11, 2021.

Cerus Corporation Announces CMS Issuance of P-Codes for Hospital Outpatient Billing of INTERCEPT-Based Therapeutic Products

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火曜日, 8月 10, 2021
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By providing a means for hospitals to bill for Cerus recently-approved products in the hospital outpatient setting, CMS decision to establish these new codes enables provider and patient access to continued innovation in transfusion medicine, said Jessica Hanover, Ph.D., Cerus vice president, corporate affairs.

Key Points: 
  • By providing a means for hospitals to bill for Cerus recently-approved products in the hospital outpatient setting, CMS decision to establish these new codes enables provider and patient access to continued innovation in transfusion medicine, said Jessica Hanover, Ph.D., Cerus vice president, corporate affairs.
  • We are pleased that these codes will facilitate hospital utilization of our new pathogen reduced blood products, which address critical unmet needs for so many patients.
  • Cerus Corporation is dedicated solely to safeguarding the worlds blood supply and aims to become the preeminent global blood products company.
  • INTERCEPT and the INTERCEPT Blood System are trademarks of Cerus Corporation.

Koya Medical Secures First Reimbursement Codes for Dayspring, for Lymphedema; Publishes Clinical Data Demonstrating Improved Function, Appearance, Mood and Symptoms

Retrieved on: 
火曜日, 8月 10, 2021
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View the full release here: https://www.businesswire.com/news/home/20210810005248/en/

Key Points: 
  • View the full release here: https://www.businesswire.com/news/home/20210810005248/en/
    The Dayspring active compression therapy system for lymphedema and venous disease.
  • Preexisting reimbursement codes have covered traditional pneumatic or air-based compression systems for more than three decades.
  • Koya also announced today that the first of its multiple clinical studies has been published in the peer-reviewed journal Lymphatic Research and Biology [1] .
  • Lymphatic Research and Biology
    [2] Dean, S. M., Valenti, E., Hock, K., Leffler, J.,Compston, A., & Abraham, W. T. (2020).