Payer retires non-coverage provisions for PTNS

May 9, 2012

Uroplasty, Inc., has announced that Novitas Solutions (formerly Highmark Medicare Services) informed the Centers for Medicare & Medicaid Services that it has retired the non-coverage provisions concerning posterior tibial nerve stimulation (PTNS) from its local coverage determination effective for services incurred on or after April 9, 2012.

Uroplasty, Inc., has announced that Novitas Solutions (formerly Highmark Medicare Services) informed the Centers for Medicare & Medicaid Services that it has retired the non-coverage provisions concerning posterior tibial nerve stimulation (PTNS) from its local coverage determination effective for services incurred on or after April 9, 2012.

Novitas Solutions is the Medicare Administrative Contractor for Delaware, Maryland, New Jersey, Pennsylvania, and the District of Columbia, providing medical and drug benefits to approximately 4.6 million Medicare beneficiaries.

"Physicians treating Medicare beneficiaries in states served by Novitas may start submitting claims for PTNS treatments immediately. Novitas will process claims for payment based on the provisions of the updated local coverage determination," said David B. Kaysen, of Uroplasty, which markets PTNS under the Urgent PC Neuromodulation System name.

Novitas will retire all provisions of the non-coverage local coverage determination as they pertain to PTNS, and will post an updated local coverage determination in accordance with its procedures on or about May 15, 2012. Novitas stated that it reversed the non-coverage provisions as a result of the recent comparative effectiveness review entitled "Nonsurgical Treatments for Urinary Incontinence in Adult Women," published by the Agency for Healthcare Research and Quality.

"This is positive news for Uroplasty concerning our Urgent PC Neuromodulation System," said Kaysen said. "The report further validates the importance and respect that payers have for this comprehensive comparative effectiveness review of urinary incontinence treatments."

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