Healthcare professionals / Gastroenterology / EXALTTM Model D Single-Use Duodenoscope / Pass-through Payment
    
    

CMS Approves Transitional Pass-through Payment Category

The Centers for Medicare & Medicaid Services (CMS) has approved Boston Scientific’s application for a transitional pass-through (TPT) payment category to describe single-use endoscopes, such as the EXALT™ Model D Single-Use Duodenoscope. Effective July 1, 2020, the new device pass-through code (C1748) may be used to bill for EXALT Model D when used in the treatment of Medicare patients in the hospital outpatient setting. This device specific payment is in addition to the ERCP procedural payment.

 

TRANSITIONAL PASS-THROUGH CODE

HCPCS Long Descriptor
C1748

Endoscope, single-use (i.e, disposable), upper GI,

imaging/illumination device (insertable)

The CMS guidance on the new device transitional pass-through category is available at:  https://www.cms.gov/files/document/r10166cp.pdf (See Section 7 and Tables 8 & 9)
   

   REPORTING FOR PROCEDURE AND DEVICE ON A CLAIM

  • When physicians perform an endoscopic retrograde cholangiopancreatography (ERCP) procedure on a Medicare patient in the outpatient setting with EXALT Model D, if appropriate, may bill:
    • Procedure coding: Appropriate ERCP CPT code(s) plus    
    • Device HCPCS code: C1748
    • Device Revenue Code: EXALT Model D is a single-use sterile device and may be reported using revenue code 278 – Medical/surgical supplies and devices; other implants.
 
For additional coding and reimbursement information, contact your local Endoscopy Field Reimbursement Manager or the Endoscopy Reimbursement Help Desk at ENDOFRM@bsci.com or (508) 683-4510.
 
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