CMS approves code for ENT implant in ASCs, hospital outpatient departments — 4 insights

CMS granted Intersect ENT’s Sinuva Sinus Implant transitional pass-through payment status for reimbursement under the Hospital Outpatient Prospective Payment System and Ambulatory Surgery Center Payment System.

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Four things to know:

1. CMS assigned the Intersect ENT product a new code: C9122 Mometasone furoate sinus implant, 10 micrograms (Sinuva).

2. The C-code is scheduled to take effect July 1, with pass-through status in ASCs and hospital outpatient settings for three years.

3. SINUVA is a non-surgical treatment option for patients with recurrent nasal polyps who have had ethmoid sinus surgery. It features a self-expanding, bioabsorbable structure and offers targeted delivery of an anti-inflammatory to the site of disease for 90 days.

4. The C-code assignment expands Sinuva coverage to about 40 million Medicare beneficiaries. More than 70 percent of commercial beneficiaries already have coverage for Sinuva, according to Intersect ENT President and CEO Thomas West.

More articles on surgery centers:
The ‘new normal’ for ASCs: 16 admins on how the pandemic will change the field forever
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Indiana orthopedic practice with surgery center to open

 

At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.

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Presenters: Joe Ganley, athenahealthJeffrey Flynn, CASC, Gramercy Surgery CenterBryan Tsao, Access Center, Loma Linda University HealthJason Zepeda, Northridge Hospital Medical Center, CommonSpirit HealthGreg DeConciliis, PA-C, CASC, Boston Out­Patient Surgical Suites

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