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

   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.