Ambulatory Payment Classification

TriSalus Life Sciences Announces CMS Reimbursement for the TriNav® Infusion System via Assignment of a New Technology Healthcare Common Procedure Coding System (HCPCS) Code

Retrieved on: 
Thursday, December 14, 2023
Biotechnology, Health, Pharmaceutical, Clinical Trials, Oncology, Abdominal ultrasonography, APC, Liver, HCPCS, Patient, Ambulatory Payment Classification, CMS, Medicare, Hospital, Immunotherapy

TriSalus Life Sciences® Inc. , (Nasdaq: TLSI), an oncology company integrating its novel delivery technology with immunotherapy to transform treatment for patients with liver and pancreatic tumors, is pleased to announce today that the Centers for Medicare & Medicaid Services (CMS) has created a New Technology Healthcare Common Procedure Coding System (HCPCS) code for procedures involving the TriNav® Infusion System.

Key Points: 
  • TriSalus Life Sciences® Inc. , (Nasdaq: TLSI), an oncology company integrating its novel delivery technology with immunotherapy to transform treatment for patients with liver and pancreatic tumors, is pleased to announce today that the Centers for Medicare & Medicaid Services (CMS) has created a New Technology Healthcare Common Procedure Coding System (HCPCS) code for procedures involving the TriNav® Infusion System.
  • This new code, HCPCS C9797, has been assigned to the Ambulatory Payment Classification (APC) 5194 - Level 4 Endovascular Procedures.
  • The new code will become effective on January 1, 2024, and may be reported by hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs).
  • “We want to thank the Centers for Medicare & Medicaid Services, our congressional supporters, our clinicians, and all the patients and hospitals that helped to ensure that patients continue to have uninterrupted access to this important technology," said Mary Szela, Chief Executive Officer of TriSalus.

HistoSonics Notches Significant Reimbursement Wins

Retrieved on: 
Monday, November 6, 2023
Radiology, Research, Insurance, Oncology, Software, Medical Devices, Hardware, Hospitals, Professional Services, Science, Technology, Clinical Trials, FDA, Biotechnology, Surgery, Health, Health Technology, Health Insurance, Liver, Sale, Medicare, Government, Diagnosis-related group, Physician, High-intensity focused ultrasound, American Medical Association, Infection, Kidney, Bleeding, Blue, Ambulatory Payment Classification, Multimedia, IDE, AMA, Tissue, APC, Diagnosis, Hospital, Centers for Medicare & Medicaid Services, CPT, Pain, Patient, Investigational New Drug, DRG, CMS, Medical imaging, Medicaid

We commend CMS on facilitating access to breakthrough devices like ours for Medicare patients, many of whom historically have had delayed access to innovative technology,” commented HistoSonics President and CEO Mike Blue.

Key Points: 
  • We commend CMS on facilitating access to breakthrough devices like ours for Medicare patients, many of whom historically have had delayed access to innovative technology,” commented HistoSonics President and CEO Mike Blue.
  • HistoSonics’ Edison Histotripsy System combines advanced imaging and proprietary software to deliver patient specific treatments and uses the science of histotripsy to mechanically destroy targeted tissues at sub-cellular levels.
  • Additionally, the American Medical Association (AMA) has recently issued a new Category III CPT code for histotripsy of kidney tissue.
  • The release of this new code represents a major reimbursement milestone as hospitals across the US will be able to submit claims directly related to the service.

CMS Confirms CPT Code 64590 for eCoin® Tibial Neurostimulator

Retrieved on: 
Wednesday, December 14, 2022
American Medical Association, CMS, Indian Medical Association, Vasculitis, Food and Drug Administration, Leg, Magnet, Food, Centers for Medicare & Medicaid Services, Edema, Nursing care plan, MRI, Pregnancy, Letter, Patient, New Technology Management, Ambulatory Payment Classification, Sores, Hospital, APC, Division, FDA, CPT, Urinary incontinence, EMI, US Foods, Trauma, PMA, Safety, Physician, Burns, AMA, Government, ASC, Infection, Diathermy, Medicare, Foot, Medical device, Pharmaceutical industry, Medical imaging

The eCoinsystem is a leadless tibial neurostimulator for the treatment of urgency urinary incontinence (UUI).

Key Points: 
  • The eCoinsystem is a leadless tibial neurostimulator for the treatment of urgency urinary incontinence (UUI).
  • CPT code 64590 is assigned to Ambulatory Payment Classification (APC) 5464.
  • The eCoin device is a coin-sized neurostimulator which is implanted subcutaneously in the lower leg during a minimally invasive, outpatient procedure utilizing local anesthetic.
  • About The eCoinSystemThe eCoin Peripheral Neurostimulator ("eCoin") is part of the eCoin Peripheral Neurostimulator System ("eCoin System") including device accessories.

EDAP Announces Final U.S. 2021 Reimbursement Rules for High Intensity Focused Ultrasound (HIFU)

Retrieved on: 
Wednesday, December 9, 2020
Relative value unit, Healthcare reform in the United States, Healthcare in the United States, High-intensity focused ultrasound, Medicare, Ambulatory Payment Classification, Applied sciences, Health, United States

On the Hospital Payment side, the final rule maintains the HIFU procedure in the Level 5 Urology Ambulatory Payment Classification (APC) in 2021.

Key Points: 
  • On the Hospital Payment side, the final rule maintains the HIFU procedure in the Level 5 Urology Ambulatory Payment Classification (APC) in 2021.
  • This represents an increase of $256, or 6%, from the payment hospitals receive from Medicare for a HIFU procedure in 2020.
  • In the Physician Fee Schedule final rule, CMS has established for the first time a payment to physicians performing a HIFU procedure in the US.
  • In the final rule, CMS has set a total Relative Value Units (RVUs) for a physician performing a HIFU procedure at 29.09.

Centers for Medicare & Medicaid Services Creates New Codes That Establish Specific Payment for Intravascular Lithotripsy Performed Below the Knee

Retrieved on: 
Friday, December 4, 2020
American Medical Association, Ambulatory Payment Classification, Healthcare in the United States, Human leg, Healthcare Common Procedure Coding System, Health

Previously, in July 2020, CMS issued four codes C9764-C9767 to describe IVL performed in all lower extremity arteries.

Key Points: 
  • Previously, in July 2020, CMS issued four codes C9764-C9767 to describe IVL performed in all lower extremity arteries.
  • As part of the 2021 OPPS final rule, these initial codes have now been redefined to report IVL procedures performed in lower extremity arteries, except tibial and peroneal.
  • Starting in January 2021, there will now be four codes that pertain to below-the-knee IVL procedures and four that pertain to above-the-knee IVL procedures.
  • In addition, CMS assigned the new HCPCS codes to Ambulatory Payment Classifications (APCs) that determine hospital outpatient payment.

Medata Launches LookUp

Retrieved on: 
Tuesday, April 28, 2020
Data management, Practice Management, Technology, Professional services, Managed care, Other Health, Health, General Health, Software, Insurance, Human resources, Healthcare in the United States, American Medical Association, Computing, Health in the United States, Healthcare Common Procedure Coding System, Health, Medicare, Ambulatory Payment Classification, Medical billing, Lookup table

Medata , a leader in medical cost containment technology, has introduced LookUp, a user-friendly, web-based medical services pricing tool.

Key Points: 
  • Medata , a leader in medical cost containment technology, has introduced LookUp, a user-friendly, web-based medical services pricing tool.
  • LookUp accesses over 1 billion medical billings through Medatas data warehouse that maintains national group health, workers compensation, auto liability, and Medicare data.
  • LookUp allows searches by CPT, NDC, HCPCS, ASA, ADA, EAPG, APC, OPPS, DME, and IPPS codes and will soon include Diagnostic Related Grouping (DRG) codes.
  • Now smaller payers, attorneys, Medicare Set-Aside companies, and consumers can access its powerful database through LookUp to check medical prices.

LogixHealth Releases Review of 2020 Outpatient Payment System Final Rule

Retrieved on: 
Wednesday, February 12, 2020
Federal assistance in the United States, Healthcare reform in the United States, Presidency of Lyndon B. Johnson, Liberalism in the United States, Medicare, Medicaid, United States, Articles, Government, Ambulatory Payment Classification

BEDFORD, Mass., Feb. 12, 2020 /PRNewswire/ -- LogixHealth has released its2020 Outpatient Payment System (OPPS) Update,a review of the 2020 Outpatient Payment System Final Rule published by the Centers for Medicare and Medicaid Services.

Key Points: 
  • BEDFORD, Mass., Feb. 12, 2020 /PRNewswire/ -- LogixHealth has released its2020 Outpatient Payment System (OPPS) Update,a review of the 2020 Outpatient Payment System Final Rule published by the Centers for Medicare and Medicaid Services.
  • The final rule establishes payment rates and policies for outpatient services furnished by hospitals thatare paid under the OPPS, and governs services provided on or after January 1, 2020.
  • LogixHealth's 2020 Outpatient Payment System Update indicates that in 2020, CMS is updating OPPS rates by 2.6%.
  • A table outlining the 2020 rates is included inLogixHealth's 2020 Outpatient Payment System Update .

TriSalus™ Life Sciences’ Surefire® Spark™ Infusion System (TriNav™) Receives CMS Approval for Transitional Pass-Through Payment Status

Retrieved on: 
Wednesday, November 20, 2019
Biotechnology, Medical devices, Health, Pharmaceutical, Oncology, Federal assistance in the United States, Healthcare reform in the United States, Presidency of Lyndon B. Johnson, Healthcare in the United States, Prospective payment system, Medicare, Medicaid, Articles, United States, Government, Ambulatory Payment Classification

TriSalus Life Sciences (formerly Surefire Medical Inc.), a company committed to treating cancer at its origins, today announced that the Centers for Medicare & Medicaid Services (CMS) granted approval for transitional pass-through (TPT) payment for its Surefire Spark Infusion System.

Key Points: 
  • TriSalus Life Sciences (formerly Surefire Medical Inc.), a company committed to treating cancer at its origins, today announced that the Centers for Medicare & Medicaid Services (CMS) granted approval for transitional pass-through (TPT) payment for its Surefire Spark Infusion System.
  • Effective January 1, 2020, Surefire Spark Infusion System (to be known as TriNav) was granted transitional pass-through payment status as part of the 2020 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System (CMS-1717-FC) final rule posted on November 1, 2019.
  • We thank CMS for its efforts to expand access to devices such as our Surefire Spark Infusion System that provide improved benefits to patients, said Mary Szela, President and CEO of TriSalus.
  • Process and Information Required to Apply for Additional Device Categories for Transitional Pass-Through Payment Status Under the Hospital Outpatient Prospective Payment System.

LogixHealth Releases Review of 2019 Outpatient Payment System Final Rule

Retrieved on: 
Thursday, February 21, 2019
Healthcare reform in the United States, Federal assistance in the United States, Presidency of Lyndon B. Johnson, Liberalism in the United States, Medicare, Medicaid, United States, Government, Ambulatory Payment Classification, Politics

BEDFORD, Mass., Feb. 21, 2019 /PRNewswire/ -- LogixHealth has released its2019 Outpatient Payment System (OPPS) Update,a review of the 2019 OPPS final rule published by the Centers for Medicare and Medicaid Services.

Key Points: 
  • BEDFORD, Mass., Feb. 21, 2019 /PRNewswire/ -- LogixHealth has released its2019 Outpatient Payment System (OPPS) Update,a review of the 2019 OPPS final rule published by the Centers for Medicare and Medicaid Services.
  • The final rule establishes payment rates and policies for outpatient services furnished by hospitals thatare paid under the OPPS, and governs services provided on or after January 1, 2019.
  • LogixHealth's 2019 Outpatient Payment System Update indicates that in 2019, CMS is updating OPPS rates by 1.35%.
  • In particular, with the complex coding rules surrounding the high-frequency hydration, injection, and infusion codes, there is significant revenue at stake for these procedures.A table outlining the 2019 rates is included inLogixHealth's 2019 Outpatient Payment System Update .