EXALT™ Model D
EXALTTM Model D Single-Use Duodenoscope / Economics
A cost-effective alternative to reusable duodenoscopes
TPT calculation provides more adequate payment for single-use scopes
Effective July 1, 2020, CMS made changes to the transitional pass-through (TPT) payment for single-use endoscopes.
Hospitals may now use TPT code C1748 to receive device-specific payment for EXALT Model D in addition to the reimbursement for the ERCP procedure.
TPT payment guide for coders
Share our TPT payment and billing information with your coding team to help ensure appropriate payment for EXALT Model D.
CMS Hospital Inpatient New Technology Add-on Payment (NTAP)
Boston Scientific continues to lead the effort to secure appropriate coding and payment for EXALT Model D.
- Medicare Hospital Inpatient New Technology Add-on Payment (NTAP): On October 16, 2020, Boston Scientific submitted an application for NTAP under Medicare’s Hospital Inpatient Prospective Payment System. If approved, this device payment will apply to single-use duodenoscopes when treating Medicare patients in the hospital inpatient setting for eligible inpatient admissions. The Centers for Medicare & Medicaid Services (CMS) will make a final determination on the application in 2021.
- Inpatient ICD-10-PCS Code: Boston Scientific has submitted a request for the creation of a unique ICD-10-PCS code to support hospitals in reporting the use of EXALT Model D during ERCP procedures when performed in the hospital inpatient setting. Boston Scientific presented this application at the September 8, 2020 ICD-10 Coordination and Maintenance Committee Meeting. CMS will make a determination on the code in 2021.
Commercial payers are not required to follow CMS coverage; however, some may choose to do so. It is recommended to reach out to commercial payers to understand commercial payer reimbursement for EXALT Model D.
New Medicare pass-through code supports adoption of single-use duodenoscopes
- How reusable duodenoscopes pose infection risks to your patients
- Why the FDA recommended a transition to “innovative duodenoscope designs”
- How single-use duodenoscopes offer a possible alternative to reusable scopes
- What Medicare’s transitional pass-through (TPT) payment means for healthcare providers using single-use duodenoscopes
Single-Use Duodenoscopes: The Economics | Dr. Ananya Das
In this episode of GI EndoCast, Dr. Ananya Das, Interventional Endoscopy, Professor of Medicine at University of Arizona and Creighton University, discusses his thoughts on:
✓ The risks and economic costs of contamination and infection with reusable scopes
✓ The results of his research on the cost-effectiveness of single-use duodenoscopes
✓ The potential cost impact of single-use scopes in terms of reducing infection rates, ICU stays and mortality rates
✓ CMS changes to the transitional pass-through (TPT) payment for single-use duodenoscopes used during ERCP procedures
Dr. Kenneth Binmmoeller
Dr. Kenneth Binmoeller discusses his thoughts on all costs involving duodenoscopes, including additional expenses and real-world costs associated with reusable scopes.
Professor Alessandro Repici
Duodenoscope costs: What is right for your hospital?
Professor Alessandro Repici talks about the hidden costs of reusable duodenoscopes and how to evaluate the cost of single-use scopes in your hospital.
The hidden costs of reprocessing
The basic reprocessing steps for reusable duodenoscopes steps include pre-cleaning, leak testing, manual cleaning, visual inspection, high-level disinfection and drying. But in practice, there can be more than 100 distinct steps that are labor-intensive and introduce the opportunity for contamination. With EXALT Model D Single-Use Duodenoscope, you can reduce the risk of infection due to reusable scope cross-contamination, increase efficiency and enable your staff to focus on other tasks.