CMS to reimburse for regenerative orthopedic product in ASCs

CMS updated the reimbursement calculation for Wright Medical’s Augment regenerative solutions to allow for Medicare beneficiaries to undergo procedures with the product in ASCs and hospital outpatient departments.

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What you should know:

1. The coverage is for the Augment Bone Graft and Augment Injectable.

2. Medicare beneficiaries can undergo hindfoot and ankle fusions in either setting now. The facility will receive the incremental cost of Augment.

3. The update was made retroactive to Jan. 1. Procedures that were billed using code C1734 will be eligible for payments.

4. Wright Medical President and CEO Robert Palmisano said, “The update to the transitional pass-through payment in the outpatient setting will help ensure healthcare providers have access to AUGMENT Regenerative Solutions, which offer a clear patient benefit by eliminating the complications of the additional surgery required to harvest autograft that can result in site-specific complications and/or prolonged harvest site pain in some patients.”

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