Largest US Private Payor Updates Medical Policy for BIS
ImpediMed Limited (ASX.IPD) today announces that UnitedHealthcare, the largest Private Payor in the U.S., updated its Commercial and Individual Exchange Medical Policy Omnibus Codes policy stating that Bioimpedance Spectroscopy (BIS) for Lymphedema Assessment (CPT Code 93702) no longer requires clinical review.
Key Points: • UnitedHealthcare (“UHC”) published Policy Number 2024T0535QQQ. • The policy was updated to state that CPT code 93702 no longer requires clinical review. • The policy has an effective date of 1 January 2024. • UHC’s previous policy, Policy Number 2023T0535PPP, stated that CPT code 93702 for BIS and extracellular fluid analysis for lymphedema assessment(s) was “unproven and not medically necessary.” This is what the Company has historically referred to as the experimental list.
• The updated policy has removed CPT code 93702 from the code section where it was previously stated as “unproven”. This is what the Company refers to as silent coverage.
A link to the policy can be found here: https://www.uhcprovider.com/content/dam/provider/docs/public/policies/index/commercial/omnibus-codes-01012024.pdf “This is a very exciting step for patients at risk of lymphoedema. We expect this change to mean that we will have silent coverage from UnitedHealthcare, when the policy goes into effect in January 2024. With this change, UnitedHealthcare will be the second Top 5 national payor to cover SOZO testing for lymphoedema. Cigna was the first”, stated Rick Valencia, Managing Director and CEO of ImpediMed. “Silent coverage is not uncommon. U.S. Medicare and 27 other Private Payors currently cover our technology through silent coverage. With the addition of UnitedHealthcare, we will achieve six (6) states at Critical Mass1 to start the calendar year”, he continued.
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