Given Imaging Announces New Reimbursement Code for Its SmartPill(R) Wireless Motility Capsule Procedure
Thursday 17 January 2013
Given Imaging Ltd (NASDAQ: GIVN), a world leader in GI medical devices and pioneer of capsule endoscopy, today announced that effective January 1, 2013, the 2013 National Average Medicare Physician Fee allowable for its recently acquired SmartPill® Wireless Motility Capsule (SmartPill) procedure is $1,188.93. This amount differs from the previously proposed $873.28, due to avoidance of the 27% tax cut that was originally expected to go into effect in 2013. SmartPill's new Category 1 CPT code is 91112. The SmartPill procedure uses sensor-based capsule technology to measure gastric emptying, small bowel transit, colonic transit and whole gut transit times to evaluate motility disorders like gastroparesis and chronic constipation.
The company believes that this new permanent CPT code confirms the value of the SmartPill procedure and may assist in submitting claims electronically. Currently, there are favorable coverage policies for the SmartPill with Medicare Palmetto GBA (J1 & 11), with 6.2 million lives covered, and with United Healthcare, with 36 million lives covered. Additionally, it is anticipated that commercial payers will also use the new allowable amount as a benchmark for their payment based on their individual contracts.
"We are very pleased about this new reimbursement code," said Homi Shamir, President and CEO of Given Imaging. "We see this as an indication of acceptance of the SmartPill technology, which is an important and patient-friendly tool for physicians caring for patients suffering from symptoms of GI motility disorders."
Traditionally, patients with symptoms of upper or lower gastromotility disorders undergo gastric emptying scintigraphy and colonic Sitzmarks™ testing. Due to the expense of conducting these types of evaluations, SmartPill can provide a cost-effective, radiation-free alternative for measuring gastric emptying and total GI transit times along with pH, pressure and temperature of the GI tract.
About SmartPill® motility monitoring system
The SmartPill motility monitoring system offers a unique way to assess motility by collecting and analyzing data from within the entire GI tract via a test that can be performed in the clinic or physician's office. The test is ambulatory, allowing the patient to go about their normal routine throughout the test. As the SmartPill capsule passes through the GI tract, it transmits data to a recorder worn by the patient. Once the single-use capsule has passed from the body, study data are downloaded from the recorder to a computer. The physician then uses MotiliGI® software to display and analyze the data, providing test results in both graphical and report formats. Results are used for the evaluation of gastroparesis and chronic constipation. The SmartPill motility monitoring system was granted initial 510(k) release from the U.S. Food and Drug Administration (FDA) in July 2006.
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