Iridex Corporation Announces Successful Appeal for Revision of Recent Medicare LCDs to Provide Broader Coverage of Cyclophotocoagulation

About this update from Iridex Corporation

[{"type":"text","content":"MOUNTAIN VIEW, Calif., Nov. 27, 2023 (GLOBE NEWSWIRE) -- Iridex Corporation (NASDAQ: IRIX), a worldwide leader providing innovative and versatile laser-based medical systems, delivery devices, and procedure probes for the treatment of glaucoma and retinal diseases, today announced its successful advocacy for revision of the recently issued Medicare Local Coverage Determinations (LCDs) for Cyclophotocoagulation (CPC). During the last few days, the five Medicare Administrative Contractors (MACs) that issued the new LCDs have all corrected errors in criteria for coverage of CPC resulting in significantly broader patient qualification in the jurisdictions of these MACs. ”We appreciate the MACs quick action, before the Effective Date of the coverage change, to assure broader patient access to the benefits of CPC,” said David Bruce, Iridex President and CEO, “and that this correction was supported by strong advocacy from the original authors of the 2001 paper cited by the MACs in setting the new coverage criteria, led by Dr. Shan Lin from the Glaucoma Center of San Francisco.” The change in criteria better aligns the LCDs with the conclusions and recommendations made by the authors of the 2001 paper, “Cyclophotocoagulation, A Report by the American Academy of Ophthalmology (AAO),” by mirroring several of the recommended indications. Specifically, the list of patient characteristics used in the criteria, which had been separated by the word “AND,” are corrected to be separated by the word “OR” and read as follows: “4. Cyclophotocoagulation will be considered medically reasonable and necessary for patients with refractory glaucoma when:a. Have failed trabeculectomy or tube shunt procedures, ORb. Minimal useful vision and elevated intraocular pressure, ORc. Have no visual potential and need pain relief.” Mr. Bruce continued, “While we are pleased with this initial coverage-enhancing step, we are preparing a subsequent appeal to further broaden the patient criteria qualifying for reimbursement in these MAC jurisdictions. We will urge MAC administrators to include the additional recommendations from the 2001 AAO paper that remain excluded from the current modified LCD to cover (i) patients that are poor candidates for invasive surgical procedures and (ii) emergency situations. Our appeal will also seek proper consideration of the technolog...

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