{"id":452333,"date":"2021-03-08T07:03:17","date_gmt":"2021-03-08T12:03:17","guid":{"rendered":"http:\/\/www.marketnewsdesk.com\/?p=452333"},"modified":"2021-03-08T07:03:17","modified_gmt":"2021-03-08T12:03:17","slug":"cms-consolidates-sinuva-sinus-implant-coverage-under-a-distinct-code-j7402-and-publishes-an-asp-clarifying-payment-and-easing-payer-coverage-adjudication","status":"publish","type":"post","link":"https:\/\/www.marketnewsdesk.com\/index.php\/cms-consolidates-sinuva-sinus-implant-coverage-under-a-distinct-code-j7402-and-publishes-an-asp-clarifying-payment-and-easing-payer-coverage-adjudication\/","title":{"rendered":"CMS Consolidates SINUVA Sinus Implant Coverage Under a Distinct Code, J7402, and Publishes an ASP Clarifying Payment and Easing Payer Coverage Adjudication"},"content":{"rendered":"

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CMS Consolidates SINUVA Sinus Implant Coverage Under a Distinct Code, J7402, and Publishes an ASP Clarifying Payment and Easing Payer Coverage Adjudication<\/b><\/p>\n

Pass-Through Status Will Continue Under the New Code Through June 30, 2023<\/i><\/p>\n

MENLO PARK, Calif.–(BUSINESS WIRE<\/a>)–
\nIntersect ENT\u00ae, Inc. (Nasdaq: XENT), a global ear, nose and throat (\u201cENT\u201d) medical technology leader dedicated to transforming patient care, today announced that the Centers for Medicare and Medicaid Services (CMS) published an average selling price (ASP) for the Company\u2019s SINUVA sinus implant, providing predictability, transparency, and confidenceof reimbursement for providers and payers going forward. In January 2021, CMS created separate and distinct codes for Intersect ENT\u2019s two bioabsorbable implant product lines PROPEL (S1091) and SINUVA (J7402). CMS has now attached an ASP to J7402, \u201cmometasone furoate sinus implant, (sinuva), 10 micrograms.\u201d Previously, a single code covered both products despite their substantial differences.\n<\/p>\n

\nAdditionally, CMS confirmed consolidation of all coding for SINUVA into the newly created Code, J7402. In so doing, CMS\u2019s action incorporates SINUVA \u201cpass-through\u201d status in ambulatory care settings with Medicare patients to the new J-Code, J7402, and eliminates the temporary sinus implant C-Code, C9122, issued in July 2020. These actions came as a result of the Company\u2019s application to CMS for clarification and simplification in coding of the products. The Company believes the separate and dedicated codes will have a positive impact on patient and physician access by improving accuracy in claims adjudication, supporting expanded use at multiple sites of service, and providing greater clarity of coverage for payers and providers.\n<\/p>\n

\n\u201cWe are pleased that CMS consolidated SINUVA coverage to a single code and published a SINUVA ASP. These actions will help better inform ENT surgeons of the amount of implant reimbursement they can expect regardless of setting of care, thereby greatly reducing the uncertainty that can come with claims submissions,\u201d stated Thomas A. West, President and Chief Executive Officer of Intersect ENT. \u201cCMS\u2019s recent decisions will also clearly differentiate coding for SINUVA and PROPEL, two very different products. This will serve to simplify and streamline coding and reimbursement across our portfolio and will support evidence-based and cost-effective care across the continuum of need in chronic rhinosinusitis.\u201d\n<\/p>\n

SINUVA\u00ae<\/sup> Steroid Releasing Sinus Implant<\/b><\/p>\n

\nSINUVA is a non-surgical, corticosteroid-eluting implant for the treatment of nasal polyps in adult patients who have had ethmoid sinus surgery. Its innovative 2-in-1 design incorporates a self-expanding, bioabsorbable implant structure along with the targeted delivery of an anti-inflammatory corticosteroid, mometasone furoate. It provides localized drug delivery for up to 90 days directly to the site of disease. By nature of its design as an office-administered implant with direct delivery of anti-inflammatory medication, SINUVA minimizes the reliance on patient compliance. SINUVA is clinically proven to reduce polyps and the need for revision nasal surgery, as well as improve the symptoms of nasal polyps, nasal obstruction, congestion and decreased sense of smell.\n<\/p>\n

About Intersect ENT\u00ae<\/b><\/p>\n

\nIntersect ENT is a global ear, nose and throat medical technology leader dedicated to transforming patient care. The Company\u2019s steroid releasing implants are designed to provide mechanical spacing and deliver targeted therapy to the site of disease. In addition, Intersect ENT is continuing to expand its portfolio of products based on the Company\u2019s unique localized steroid releasing technology and is committed to broadening patient access to less invasive and more cost-effective care. In October 2020, Intersect ENT acquired Fiagon AG Medical Technologies, a global leader in electromagnetic surgical navigation solutions with an expansive portfolio of ENT product offerings, including the VENSURE sinus dilation balloon, that complement the Company\u2019s PROPEL\u00ae<\/sup> and SINUVA\u00ae<\/sup> sinus implants and extend its geographic reach.\n<\/p>\n

\nFor additional information on the Company or the products including risks and benefits please visit www.IntersectENT.com<\/a>. For more information about PROPEL\u00ae (mometasone furoate) sinus implants and SINUVA\u00ae (mometasone furoate) sinus implant, please visit www.PROPELOPENS.com<\/a> and www.SINUVA.com<\/a>.\n<\/p>\n

\nIntersect ENT\u00ae, PROPEL\u00ae and SINUVA\u00ae are registered trademarks of Intersect ENT, Inc.\n<\/p>\n

SINUVA Indication & Important Safety Information<\/b><\/p>\n

\nINDICATION\n<\/p>\n

\nSINUVA Sinus Implant is a prescription steroid-releasing (mometasone furoate) implant indicated for the treatment of nasal polyps in patients 18 years or older who have had ethmoid sinus surgery.\n<\/p>\n

\nIMPORTANT SAFETY INFORMATION\n<\/p>\n

\nWho should not use SINUVA?\n<\/p>\n

\nDo not use SINUVA if you are allergic to mometasone furoate or any ingredients of the implant.\n<\/p>\n

\nWhat should I tell my doctor before receiving SINUVA?\n<\/p>\n

\nBefore you receive SINUVA, tell your doctor about all medical conditions you have including nasal\/sinus problems (such as nasal ulcers or trauma), eye problems (such as glaucoma or cataracts), or any untreated fungal, bacterial, or viral infections.\n<\/p>\n

\nWhat are the possible side effects of SINUVA?\n<\/p>\n

\nSerious side effects of SINUVA can include:\n<\/p>\n