Given Imaging Targeting M2A Reimbursement Beyond Obscure Bleeding
This article was originally published in The Gray Sheet
Executive Summary
A BlueCross BlueShield TEC assessment supporting capsule endoscopy for Crohn's disease diagnosis furthers Given Imaging's efforts to obtain coverage for indications beyond obscure bleeding
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PillCam ESO on the road to reimbursement
Given Imaging's miniature camera pill for detecting esophageal disorders should be described by CPT code 91110 along with a modifier 52, according to CMS. The decision will allow hospitals to uniformly report the procedure, with payment to be decided on a case-by-case basis until a coverage policy is determined. With coding in place, Given will be able to focus on securing coverage. The firm's first product - PillCam SB for small bowel disorder detection - is reimbursed under CPT code 91110 (1"The Gray Sheet" Nov. 17, 2003, p. 7)...