Replies to post #46055 on The Friendly Money Making Board

[illegal_alias]

I would agree

[Manti]

TSON news (8k):

TranS1 Inc., a Delaware corporation (the "Company") has previously disclosed that healthcare providers rely on third-party payors, including private health insurance plans, to pay for all or a portion of the costs and fees associated with the Company's pre-sacral approach and AxiaLIF interbody fusion procedure. Historically, there has been a lack of consistent reimbursement for the specific CPT code (used to describe specific services performed by physicians when submitting reimbursement claims) used to describe the AxiaLIF interbody fusion surgery, such that some physicians have found it difficult to obtain reimbursement for the procedure.

However, the Company has recently been informed that Horizon Blue Cross Blue Shield of New Jersey ("Horizon"), a major private health benefits company, has recently updated its Lumbar Spinal Fusion Policy (the "Policy") to provide reimbursement coverage for medically necessary interbody fusion procedures when using the Company's pre-sacral AxiaLIF approach. Horizon has also updated the Policy index to include reference to AxiaLIF and other interbody fusion techniques, including ALIF, DLIF, XLIF and TLIF. The Company has confirmed with Horizon that CPT codes 0195T and 0196T, which are the CPT codes associated with the Company's pre-sacral AxiaLIF procedure, will be deemed eligible for coverage when the medical necessity fusion criteria set forth in the Policy are met. According to Horizon's public filings, it represents approximately 3.6 million covered lives. To the Company's knowledge, this coverage decision for the pre-sacral approach to interbody fusion represents the second such decision by a major health benefits company in the United States.