EXALT^TM 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.

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. 
  

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
  

Physician perspectives

Operational costs

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.