Medtronic Plc. · NYSE:MDT
Medtronic — Investor Presentation (March 2017)
16 slides from Medtronic's investor presentation, Mar 20, 2017
Slide 1: Micra Transcatheter Pacing System (TPS) Reimbursement Overview
MICRA ™ TRANSCATHETER PACING SYSTEM (TPS) REIMBURSEMENT OVERVIEW MARCH 20, 2017
Slide 2: Disclaimer
DISCLAIMER This presentation is intended only for educational use. Any duplication is prohibited without written consent of the authors. This information does not replace seeking coding advice from the payer and/or your coding staff. The ultimate responsibility for correct coding lies with the pro
Slide 3: Agenda
AGENDA Micra Overview Leadless Pacemaker Coverage Decision Micra Coding Overview Reimbursement Overview Micra – Frequently Asked Questions
Slide 4: Cardiac Pacing Milestones
CARDIAC PACING MILESTONES Rate MRI External Implantable Responsive Conditional Leadless Pacemaker Pacemaker Pacemaker Pacemaker Pacemaker 1958 1960 1986 2011 Today 4
Slide 5: Leadless Pacemakers
LEADLESS PACEMAKERS Leadless (intracardiac) pacemakers deliver the same therapy as a conventional single chamber pacemaker, with fewer complications.1 Leadless pacemakers are an advanced technology in which the generator and the electrode are combined into a single device implanted entirely with
Slide 6: CMS National Coverage Analysis Timeline for Leadless Pacemaker Medicare Coverage
CMS NATIONAL COVERAGE ANALYSIS1,2 TIMELINE FOR LEADLESS PACEMAKER MEDICARE COVERAGE Maximum 6 Months 30 Days 30 Days 60 Days Max National Public Draft Decision Public Final Decision NCD Policy in Coverage Comments Memo Posted Comments Memo Posted Effect – Micra Analysis (NCA) Due Due (NCD) Implants
Slide 7: Coverage Information for Micra Implants
MICRA COVERAGE INFORMATION FOR MICRA IMPLANTS Medicare Private Payer • CMS released the final NCD for Leadless Varies by Payer Policy Pacemakers on January 18, 2017 requiring Coverage with Evidence Development (CED).1 • We encourage physicians to address with private payers on an individual patient
Slide 8: Coding Procedure Information for Micra Implants
MICRA CODING PROCEDURE INFORMATION FOR MICRA IMPLANTS Follow-up Codes1 Implant Codes1 (In person) Category III Code: 0389T2 Category III Code: Physician ( Programming) 0387T2 0391T2 ( Interrogation) ICD-10-PCS Procedure Hospital Inpatient3 Code: 02HK3NZ3 Category III Code: Hospital Outpatient 0387T2
Slide 9: Additional Required Billing Information
ADDITIONAL REQUIRED BILLING INFORMATION MEDICARE ONLY Medicare claims in a qualified clinical trial require additional codes and modifiers1 National Clinical Trial (NCT) • FDA Post Approval Study (NCT02536118), OR Identifier Number • Prospective, Longitudinal Study (NCT03039712) Z00.6 – Encounter fo
Slide 10: Reimbursement Overview: Medicare National Payment Rates
MICRA REIMBURSEMENT OVERVIEW MEDICARE NATIONAL PAYMENT RATES* Micra Traditional IPG Physician Payment1 Contractor Priced $491 DRG 242 (w MCC): DRG 228 (w MCC): $21,626 Hospital $41,414 DRG 243 (w CC): Inpatient2,3 $15,392 DRG 229 (w/o MCC): $27,733 DRG 244 (w/o CC/MCC): $12,502 Hospital C - APC 5194
Slide 11: Additional Billing Resource Can Be Found on the Medtronic Website
ADDITIONAL BILLING RESOURCE CAN BE FOUND ON THE MEDTRONIC WEBSITE http://www.medtronic.com/us-en/healthcare-professionals/products/cardiac-rhythm/coding- coverage-reimbursement-resources.html 11
Slide 12: Reimbursement FAQs
MICRA REIMBURSEMENT FAQS Q. Does Micra follow the same CMS National Coverage Determination (NCD)1 Cardiac Pacemaker Evaluation Services guidelines? A. Yes, Micra is a single chamber pacemaker device that we believe falls under these guidelines. You should check with your Medicare Administrative Cont
Slide 13: Reimbursement FAQs
MICRA REIMBURSEMENT FAQS Q. I understand the Micra physician codes are Category III CPT1 codes that have no assigned Medicare RVUs for the calculation of Medicare physician payment. How then does a physician get paid? A. Physicians submitting a Medicare claim for the Micra implant are advised to ref
Slide 14: Thank You! Any Questions?
THANK YOU! ANY QUESTIONS? PLEASE SEND FUTURE QUESTIONS VIA EMAIL TO: RS.HEALTHCAREECONOMICS@MEDTRONIC.COM VISIT MEDTRONIC’S REIMBURSEMENT WEBSITE AT: HTTP://WWW.MEDTRONIC.COM/US-EN/HEALTHCARE- PROFESSIONALS/PRODUCTS/CARDIAC-RHYTHM/CODING-COVERAGE- REIMBURSEMENT-RESOURCES.HTML
Slide 15: Brief Statement: Micra Transcatheter Pacing System
BRIEF STATEMENT: MICRA TRANSCATHETER PACING SYSTEM VVIR SINGLE CHAMBER WITH SURESCANTM MRI Indications Micra Model MC1VR01 is indicated for patients with: symptomatic paroxysmal or permanent high grade AV block in the presence of AF, symptomatic paroxysmal or permanent high grade AV block in the
Slide 16: Brief Statement: Warnings and Precautions
BRIEF STATEMENT: MICRA TRANSCATHETER PACING SYSTEM VVIR SINGLE CHAMBER WITH SURESCANTM MRI Warnings and Precautions End of Service (EOS) – When the EOS condition is met, the clinician has the option of permanently programming the device to Off and leaving it in the heart, or retrieving the device, p