Medtech

While we view today’s update of Medicare Administrative Contractor (MAC) WPS’s billing and coding article for hypoglossal nerve stimulation (HGNS) – omitting requirements that physicians bill using a -52 (reduced work) modifier – as directionally…

We estimate that iRhythm (IRTC) faces a 1%-2% growth headwind from a finalized local coverage determination (LCD) on ambulatory cardiac monitoring (ACM), likely to be released in the coming weeks. While we expect the company’s…

With government policy in a seemingly endless state of flux, we offer investors our quarterly lookahead to what we view as the most relevant catalysts across the medtech, biopharma, diagnostics, and life science tools (LST)…

Despite recent speculation that Medicare Administrative Contractors (MACs) may not pursue a formal coverage policy for GKOS iDose procedures, we continue to expect a draft local coverage determination (LCD) in Q2 / Q3. Following the…

As we had anticipated, the American Medical Association’s (AMA) CPT Editorial Panel will evaluate the creation of a new reimbursement code to describe single lead hypoglossal nerve neurostimulation (HGNS) devices (e.g., INSP’s Inspire V) at…

We see little practical reimbursement impact for INSP from CMS’s announcement this morning that it will be creating a set of new facility level C-codes for newer generation hypoglossal nerve stimulation (HGNS) device services (e.g.,…

In advance of the CMS draft coverage decision for transcatheter aortic valve replacement (TAVR) due June 15 (final Sept. 15), we expect policy changes that – while positive – may be more incremental in their…

With INSP confirming our suspicion last night that MACs will ultimately require Inspire V procedures to be billed under CPT 64582 with a -52 (reduced work) modifier, we would expect this to translate into a…

We view CareDx (CDNA) as having potentially asymmetric downside risk going into the final MolDx local coverage determination (LCD) on organ transplant rejection, which we would expect to be released in the next 1-2 months…

CMS’s update this morning – indicating that CPT 64568 is not covered for obstructive sleep apnea under any national coverage determination (NCD) – is in keeping with the view we articulated just two weeks ago,…