CMS clears retinal prosthesis system for payments

Sylmar, CA-Second Sight Medical Products Inc.’s retinal prosthesis system has been approved by the Centers for Medicare and Medicaid Services (CMS) for both inpatient and outpatient settings of care payments beginning Oct. 1.

Cases involving the technology, Argus II, which are eligible for new technology add-on payments under the Medicare inpatient prospective payment system, will be identified by the new ICD-9-CM procedure code 14.81.

The payment will also be available to all hospital outpatient facilities and ambulatory surgical centers (ASCs) that perform the procedure for Medicare beneficiaries, and will be identified by the 0100T CPT code.

“We are excited that CMS recognizes that the (retinal prosthesis system) provides a substantial clinical benefit to patients and meets all of the criteria for both of these payments,” said Brian Mech, vice president of business development at Second Sight. “This news greatly facilitates access to the (technology) for Medicare beneficiaries regardless of the setting of care in which the system is provided.”

Guideline information on billing, coding, and payment for hospital outpatient departments and ASCs will be provided by CMS on or before Sept. 1.

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