I've seen where NeuroMetrix has announced that the AMA will assign NC-Stat a level 1 CPT code to begin in Jan. 2010. Why has'nt the stock price taken off? Would'nt this new code allows MD's to properly bill Medicare and get reimbursed? Has the damage been done with the companies reputation that this new code does'nt matter?
Would welcome comments from some of you posters who are more familiar with this company (i.e. Larry etc.)
There are so many factors that screw things up for the whole process.
1. Electrodiagnostics (NCV/EMG) need to be performed by people trained in these studies.
This is not the case. With NC-Stat, Neural-scan, countless mobile NCV companies. While these studies are useful, the family doctors are only using them because they are making money from it. Let's say a family doctor suspects his son has a radiculopathy. We all know he is going to send him to a neurologist or PM&R to get diagnosed.
2. So many of these studies are getting reimbursed when they shouldn't.
As stated previously, the person behind the desk at BCBShield doesn't care what is going in front of them. They just want to get their work dome for the day.
3. Most state medical boards don't have defined rules on who performs the studies.
AMA, AANEM, Medicare, and all major insurances have regulations on these studies but that doesn't hold the family doctor responsible because (as you stated) they don't audit them.
Those are just 3 of the bigger factors. There are plenty more out there.
My guess at the problem -- so far no guidance whether the reimbursement for the NC-Stat procedure under the new code would allow practitioners to make adequate profit given current costs.
Any other ideas?
A CPT Code 1 (that the company claims they will get), allows MD's to bill at the highest level I believe. For example, an NCV test done and billed to and reimbursed at Medicare rates would give the practice about $700-$800. Minus the cost of the sensors that's a nice profit for them.
There was speculation that they would get a CPT Code 3 which would not make it profitable enough for them, however, if this CPT 1 comes through in 2010 then things might happen.