By Diagnostics World Staff
October 31, 2016 | MDxHealth announced that its ConfirmMDx for Prostate Cancer test has been granted a Category I MAAA Current Procedural Terminology (CPT) code by the American Medical Association (AMA).
Last month, MDxHealth signed a distribution agreement with The European Health Centre Innovation (EHC Innovation) to offer its SelectMDx(TM) for Prostate Cancer and ConfirmMDx for Prostate Cancer tests to their urology customers throughout Poland. The company also signed a distribution agreement with Teva to offer its SelectMDx for Prostate Cancer test to Teva's urology customers throughout Israel in August.
"Obtaining Category I CPT code for ConfirmMDx is an important reimbursement milestone that can only be achieved once there is sufficient evidence demonstrating the test improves patient outcomes, has the support of the specialty medical associations, inclusion in medical guidelines, and widespread physician adoption," stated Dr. Jan Groen, CEO of MDxHealth in a statement. "We believe that ConfirmMDx has become a ‘standard of care’ for the management of men with a previously negative prostate biopsy, and that this Category I designation will facilitate negotiations with payers and, most importantly, timely reimbursement."
CPT Category codes are granted and regulated by the AMA CPT Editorial panel and are widely used by government payers and insurance companies to describe health care services and procedures for reimbursement purposes. The unique ConfirmMDx CPT code, effective in January 2018, will streamline reimbursement from US government programs such as Medicare and Medicaid and commercial health insurance companies.
Criteria for the Category I MAAA designation include literary documentation of clinical efficacy and consistency with current medical practice, as well as widespread adoption and use across the US and with a frequency consistent with intended clinical use.