New Code Enables Reimbursement to Hospital Outpatient Centers Using MolecuLight i:X
Toronto, CANADA – (June 11, 2020) MolecuLight Inc., the leader in point-of-care fluorescence imaging for real-time detection of bacteria in wounds, announces that the Centers for Medicare & Medicaid Services (CMS) has assigned an Ambulatory Payment Classification (APC) code 5722 for the MolecuLight i:X imaging procedure for point-of-care real-time fluorescence wound imaging for bacterial presence, location and load (CPT® code 0598T (Category III)). The new APC code is effective July 1, 2020 and enables facility reimbursement under the Medicare Hospital Outpatient Prospective Payment System (OPPS), with a 2020 hospital outpatient payment rate of approximately $253.10 USD. This is in addition to the two category III CPT codes (0598T and 0599T), which also become active on July 1, 2020, that enable physicians to request payment from payers for their work providing the MolecuLight i:X imaging procedure.
“It is an important reimbursement milestone for MolecuLight that CMS, the largest payer for health care in the US, has reviewed the large body of supporting evidence and recognized the medical necessity of the MolecuLight procedure and therefore granted an APC assignment”, says Anil Amlani, MolecuLight’s CEO. “MolecuLight is dedicated to advancing the quality of clinical information provided to physicians at the time it is most needed to immediately improve patients’ treatments and outcomes.”
The MolecuLight i:X is the world’s first and only portable imaging device that provides information about bacteria causing infection at the point-of-care, allowing physicians to better chart their course to heal wounds. Bacteria in wounds causes healing delays of weeks to months and results in costly patient visits and procedures. There are over 6 million procedures provided to wound care patients annually in the US. With improved detection of the bacteria and information provided on bacterial location and load, the MolecuLight i:X-enabled procedure is positioned to facilitate improved wound care to millions of patients.
“Implementing the use of the MolecuLight i:X at Northwell has transformed our wound assessment and bacterial management practices”, says Dr. Alisha Oropallo, Director of the Comprehensive Wound Healing and Hyperbaric Center, Northwell Health, Lake Success, NY. “The device provides essential diagnostic information at the point-of-care on the presence of bacteria in wounds that has dramatically improved our treatment planning and patient care. This information is vital to our wound clinicians for assessing, triaging, and monitoring wound patients and I see this technology as the future standard of care for wound treatment”.
The new CPT procedure codes (0598T and 0599T) may be applied when using the MolecuLight i:X bacterial imaging device to identify bacteria in wounds at loads greater than 104 colony forming units (CFU) per gram. While coding and assignment to an APC enables reimbursement, each payer must decide on coverage based on the medical necessity of the patient encounter.
In the US, MolecuLight sells its products exclusively through its direct Sales team and is headquartered in Pittsburgh, PA. MolecuLight’s Sales and Clinical Applications teams provide clinical demonstrations and deliver MolecuLight’s comprehensive training program to support customers and the ongoing adoption of the i:X device and associated procedure.
*NOTE: CPT is a registered trademark of the American Medical Association.
About MolecuLight Inc.
MolecuLight Inc. (www.moleculight.com) is a privately-owned medical imaging company that has developed and is commercializing its proprietary fluorescent imaging platform technology in multiple clinical markets. MolecuLight’s first commercially released device, the MolecuLight i:X® fluorescence imaging system and its accessories are used for the detection of bacteria and digital wound measurement, and to provide a point-of-care handheld diagnostic tool for the global wound care market. The MolecuLight i:X provides clinicians with information about the fluorescent characteristics of wounds containing bacteria to assist in making improved diagnostic and treatment decisions. The company is also commercializing its unique fluorescence imaging platform technology for other markets with globally relevant, unmet needs including food safety, consumer cosmetics and other key industrial markets.
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