May 22 2017
PLYMOUTH, Minnesota—Entellus Medical, Inc. (NASDAQ: ENTL), a medical technology company focused on delivering superior patient and physician experiences through products designed for the minimally invasive treatment of chronic and recurrent sinusitis patients, as well as the treatment of patients with Eustachian tube dysfunction, today announced that the CMS has established a unique billing code and payment for endoscopic balloon dilation to treat Eustachian tube dysfunction (ETD). The code, C9745, will become effective July 1, 2017 and will facilitate payment for the outpatient treatment of ETD using balloon dilation in hospitals and ambulatory surgery centers (ASC).
“We are pleased by CMS’s decision to establish payment for endoscopic balloon dilation to treat ETD,” said Robert White, President and Chief Executive Officer of Entellus Medical. “The new payment code is associated with a national average payment of $4,130 in the hospital outpatient department, a payment that is consistent with those made for balloon dilations of the various sinus cavities in patients with chronic and recurring acute sinusitis. With the creation of a unique code and payment that is intended to cover the cost of the device and procedure, CMS removed one of the biggest obstacles to providers who seek to bring this innovative new treatment to their patients.”
C codes are unique temporary pricing codes that were initially established by CMS for the Hospital Outpatient Prospective Payment System (HOPPS) to promote the adoption of new medical technology that otherwise had no codes to facilitate payment. These payment codes are typically available for two to three years and Entellus believes, based on long-standing CMS policy, that billing code and payment for endoscopic balloon dilation to treat ETD will be effective through the end of 2019. C codes are used on Medicare HOPPS claims but may also be recognized on claims from other providers or by other payment systems.
About Entellus Medical, Inc.
Entellus Medical is a medical technology company focused on delivering superior patient and physician experiences through products designed for the minimally invasive treatment of patients. Entellus products are used for the treatment of adult and pediatric patients with chronic and recurrent sinusitis, as well as adult patients with persistent Eustachian tube dysfunction. The Entellus Medical platform of products provides effective and easy-to-use solutions intended to help simplify everything from diagnosis and patient selection, to complex case revisions and post-operative care. Entellus Medical’s core product lines, XprESS™ ENT Dilation System, MiniFESS™ Surgical Instruments, XeroGel Nasal Dressing and FocESS™ Imaging & Navigation, combine to enable ENT physicians to conveniently and comfortably perform a broad range of procedures in the office and simplify treatment based in the operating room. Entellus Medical is committed to broadening its product portfolio with high-quality and purposeful innovations for the global ENT market.