CMS grants Vistogard® New Technology Add-on Payment Effective October 1, 2016
The CMS decision means that Medicare will pay up to 50% reimbursement of the cost of Vistogard® in the hospital setting (up to $37,500), and it is expected to stay in place for two years until the cost of Vistogard® is included in the recalibration of diagnosis-related group (DRG) payments.
Vistogard® will have a unique ICD-10 procedure code XW0DX82 (introduction of Uridine Triacetate into Mouth and Pharynx). This code needs to be included by hospital billing within the first 25 ICD-10 procedure codes reported on the UB-04 claim form to receive the add-on payment.
Vistogard® is indicated for the emergency treatment of adult and pediatric patients following a fluorouracil or capecitabine overdose (chemotherapy medications).