CMS issues code for GI-focused nutrition product

CMS has provided a new Healthcare Common Procedure Coding System code for a medical nutrition product designed for individuals who struggle to absorb fat.

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Encala is a medical food that contains essential fatty acids and helps patients easily absorb the necessary healthy calories. It has been shown to help patients suffering from malabsorption, which can be caused by gastrointestinal disorders, intestinal inflammation or damage/surgery along the gastrointestinal tract, according to Envara Health, developer of the product.

CMS establishing the S9432 code, “medical foods for inborn errors of metabolism,” is a breakthrough for needed clinical nutrition solutions to become more widely available, the company said in an Aug. 26 news release. The code will take effect Oct. 1.

A National Institutes of Health-funded study found that Encala helped people with cystic fibrosis absorb more fat calories, essential fatty acids and fat-soluble vitamins, allowing them to achieve and maintain weight and body mass index targets, according to Envara Health.

Envara Health was founded in 2017 by Virginia Stallings, MD, a pediatric gastroenterologist at Children’s Hospital of Philadelphia, and Jim O’Connell, an entrepreneur and investor who serves as CEO. 

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