Released on Jul 21, 2020

New Medicare Pass-Through Code for Single-Use Endoscopes



The Centers for Medicare & Medicaid Services (CMS) has released a new device pass-through code (C1748) for single-use endoscopes, for example the EXALT™ Model D Single-Use Duodenoscope. This code is specific to the single-use technology and not the specific model.
 
C1748 - Endoscope, single-use (i.e. disposable), upper GI, imaging/illumination device (insertable)
 
Beginning July 1, 2020, hospitals may use C1748 to bill single-use upper GI endoscopes when used in the treatment of Medicare patients in the hospital outpatient setting for endoscopic retrograde cholangiopancreatography (ERCP) procedures. This device-specific payment is in addition to the payment for the following ERCP procedures:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What is the reimbursement?
It is important to note that Medicare does not set specific payments for pass-through codes. As per federal regulation, pass-through device payment is the hospital's charge for the device, adjusted to the actual cost for the device, minus the amount included in the APC payment amount for the device, located in Table 9 of CMS Transmittal 10166 for C1748.

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About Gastrointestinal Endoscopy
Gastrointestinal endoscopic procedures allow the gastroenterologist to visually inspect the upper gastrointestinal tract (esophagus, stomach and duodenum) and the lower bowel (colon and rectum) through an endoscope, a thin, flexible device with a lighted end and a powerful lens system. Endoscopy has been a major advance in the treatment of gastrointestinal diseases. For example, the use of endoscopes allows the detection of ulcers, cancers, polyps and sites of internal bleeding. Through endoscopy, tissue samples (biopsies) may be obtained, areas of blockage can be opened and active bleeding can be stopped. Polyps in the colon can be removed, which has been shown to prevent colon cancer.

About the American Society for Gastrointestinal Endoscopy
Since its founding in 1941, the American Society for Gastrointestinal Endoscopy (ASGE) has been dedicated to advancing patient care and digestive health by promoting excellence and innovation in gastrointestinal endoscopy. ASGE, with more than 15,000 members worldwide, promotes the highest standards for endoscopic training and practice, fosters endoscopic research, recognizes distinguished contributions to endoscopy, and is the foremost resource for endoscopic education. Visit www.asge.org and www.screen4coloncancer.org for more information and to find a qualified doctor in your area.

 

American Society for Gastrointestinal Endoscopy
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