".... In 2015, new Category III reimbursement CPT codes for multi-fraction electronic brachytherapy applications for skin, breast and gynecological cancers were approved by the American Medical Association (AMA) and are expected to be active as of January 2016. Coverage policies and payment values associated with the new CPT codes will be determined by the regional U.S. Medicare Administrative Contractors."
The reason why Noridian decided not to pay physicians based on CPT0182T is because the code was created based on cost submitted for breast cancer treatment in an Operating Room setting.
The company ICAD has been working with American Medical Association (AMA) on these new CPT codes which is specifically for skin cancer for several year. The 10-K basically states that these code will go live in 2016. So in 2016, Noridian will HAVE to go back to paying physicians based on these newer codes - which will be fair, but not as high as 0182T.
I think a big institutional investor dumped a #$%$ load of their shares because their analyst misinterpreted Noridian's action.
....Sure, yes we did and this is public information back in July. We submitted for a dedicated skin eBx multi fraction code. Up until then we have been billing in what would be a more general multi fraction eBx code, including Breast APBI and GYN procedures.
And we felt since the momentum had been so significant in terms of the volume of procedures that we are doing in skin, that we would be best served for the long term, by having a dedicated code that would be able to stand on its own and whether its clinical data, cost data, outcome data and so forth, we would be in a position to generate a reimbursement consistent with that particular procedure and not cloud it potentially with other procedures.
There was a panel meeting in October, which we attended. Had very, very constructive interaction with the American Medical Association and the appropriate societies and I would say we are very optimistic as it relates to the future and how this whole process will play out with that said until the meds (ph) are published, probably sometime in November. We’ll just have to wait to see if our optimism is validated.