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CMS approves code for ENT implant in ASCs, hospital outpatient departments — 4 insights


CMS granted Intersect ENT's Sinuva Sinus Implant transitional pass-through payment status for reimbursement under the Hospital Outpatient Prospective Payment System and Ambulatory Surgery Center Payment System.

Four things to know:

1. CMS assigned the Intersect ENT product a new code: C9122 Mometasone furoate sinus implant, 10 micrograms (Sinuva).

2. The C-code is scheduled to take effect July 1, with pass-through status in ASCs and hospital outpatient settings for three years.

3. SINUVA is a non-surgical treatment option for patients with recurrent nasal polyps who have had ethmoid sinus surgery. It features a self-expanding, bioabsorbable structure and offers targeted delivery of an anti-inflammatory to the site of disease for 90 days.

4. The C-code assignment expands Sinuva coverage to about 40 million Medicare beneficiaries. More than 70 percent of commercial beneficiaries already have coverage for Sinuva, according to Intersect ENT President and CEO Thomas West.


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