Mauna Kea Technologies, a leader in the optical biopsy market and developer of Cellvizio®, a confocal endomicroscopy system for GI endoscopy, bronchoscopy and preclinical imaging, announced that the Centers for Medicare and Medicaid Services (CMS) released the hospital outpatient payment rates for the 2013 Current Procedural Terminology (CPT®) codes that will be used with Cellvizio procedures in the upper gastrointestinal tract beginning Jan. 1, 2013.
The Category I CPT procedure codes issued by the American Medical Association (AMA) and supported by the medical societies, include 43206 for adding Cellvizio imaging to endoscopies specifically in the esophagus and 43252 for the entire upper GI tract. The CMS fee schedule indicates that Cellvizio procedures in the esophagus or the rest of the upper GI tract be reimbursed at an average payment rate of $927 per outpatient visit under Ambulatory Payment Classification 419. Physicians may also use these same codes to describe their services. Based on the documentation submitted with the claim and the value of similar services, Medicare Administrative Contractors will determine the appropriate payment amount.
"We are very pleased that AMA and CMS have created new codes to describe Cellvizio, which is recognized to be an important tool to manage patients with diseases of the gastrointestinal tract, and in particular in the esophagus," said Sacha Loiseau, PhD, founder and CEO of Mauna Kea Technologies, in a company press release. "We believe the new codes will ease and streamline the claims processing burden for hospital outpatient departments, facilitate payment timing and increase the predictability of hospital payments for upper GI Cellvizio procedures.