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Pacira Pharmaceuticals announces new CMS reimbursement for Exparel
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Pacira Pharmaceuticals Inc. announced that CMS has finalized a policy to provide separate Medicare reimbursement for Exparel when it is administered in ASCs. The policy becomes effective on Jan. 1, 2019.
According to a Pacira press release, the product-specific billing code of C9290 will be used for Exparel (bupivacaine liposome injectable suspension) administered at an ASC.
Used in over 4 million U.S. patients to date, according to the release, bupivacaine liposome injectable suspension is indicated for single-dose infiltration in adults to produce postsurgical local analgesia and as an interscalene brachial plexus nerve block to produce postsurgical regional analgesia.
“We are pleased to receive separate reimbursement from Medicare in the ASC, and also to receive the unique D-code for Exparel from the ADA. We believe these developments will significantly simplify the reimbursement process for clinicians and facilities utilizing the product, thus improving patient access and accelerating the transition of certain procedures to the ambulatory surgical center setting,” Dave Stack, chairman and CEO of Pacira, said in the release. “We expect the reinstatement of C9290—the original C-code for Exparel, which is still utilized by some commercial payers—to facilitate a more efficient rollout among commercial payers as they standardize around Medicare rates and practices.”
Reference:
investor.pacira.com/phoenix.zhtml?c=220759&p=irol-newsArticle&ID=2375155