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Intersect ENT’s Sinuva Adoption to Rise on New C-Code by CMS

This latest reimbursement development broadens Intersect ENT's (XENT) already-extensive customer base to a significant extent. Read More...

<p class="canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm" type="text" content="Intersect ENT, Inc. XENT recently announced major progress with respect to the reimbursement of its SINUVA Sinus Implant. According to the company, Centers for Medicare &amp; Medicaid Services (CMS) has finally granted Sinuva Sinus Implant transitional pass-through payment status for reimbursement under the Hospital Outpatient Prospective Payment System and Ambulatory Surgery Center Payment System.” data-reactid=”12″>Intersect ENT, Inc. XENT recently announced major progress with respect to the reimbursement of its SINUVA Sinus Implant. According to the company, Centers for Medicare & Medicaid Services (CMS) has finally granted Sinuva Sinus Implant transitional pass-through payment status for reimbursement under the Hospital Outpatient Prospective Payment System and Ambulatory Surgery Center Payment System.

A new C code, C9122 Mometasone furoate sinus implant, 10 micrograms (Sinuva) has been assigned to this device and will be effective from Jul 1, 2020. The pass-through payment status of this temporary pricing codewill last for three years.

<p class="canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm" type="text" content="Sinuva at a Glance” data-reactid=”14″>Sinuva at a Glance

SINUVA is a non-surgical approach to treat recurrent nasal polyp disease in adult patients who have undergone ethmoid sinus surgery. This is a corticosteroid-eluting implant with targeted delivery of an anti-inflammatory steroid (mometasone furoate) directly to the site of disease for 90 days. In the clinical study, less than half of the patients treated with SINUVA were still indicated for sinus surgery following treatment.

<p class="canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm" type="text" content="How C-Code Will Benefit Intersect?” data-reactid=”16″>How C-Code Will Benefit Intersect?

This latest reimbursement development is expected to boost Sinuva’s already-extensive customer base significantly, thereby contributing strongly to Intersect ENT’s business line that particularly focuses on developing innovative therapies for chronic sinusitis patients.

 

Per management, more than 70% commercial beneficiaries already have coverage for Sinuva. The latest C-code by CMS further expands access to SINUVA to approximately 40 million additional Medicare beneficiaries.

<p class="canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm" type="text" content="Sinuva’s J-Code Related Progress So Far” data-reactid=”27″>Sinuva’s J-Code Related Progress So Far

<p class="canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm" type="text" content="Within a short period of time, the SINUVA business line has made considerable advancement with market access and field force balance. SINUVA’s accomplishments included a positive clinical experience and meaningful advances plus product access.

In October 2019, Sinuva was assigned a specific J-code — J7401 by the CMS. Going by Medical Bbilling and Coding, J-codes, are for example, the codes for non-orally administered medication and chemotherapy drugs. J-codes are some of the most commonly used Healthcare Common Procedure Coding System (HCPCS) Level II Codes.” data-reactid=”28″>Within a short period of time, the SINUVA business line has made considerable advancement with market access and field force balance. SINUVA’s accomplishments included a positive clinical experience and meaningful advances plus product access.

In October 2019, Sinuva was assigned a specific J-code — J7401 by the CMS. Going by Medical Bbilling and Coding, J-codes, are for example, the codes for non-orally administered medication and chemotherapy drugs. J-codes are some of the most commonly used Healthcare Common Procedure Coding System (HCPCS) Level II Codes.

Sinuva recently noted that, in January and February, it received favorable fee schedule treatment from several national commercial payers for use of the J-code, which showed early benefits.

<p class="canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm" type="text" content="Market Prospects” data-reactid=”30″>Market Prospects

Introduction of technologies and rapid innovations in healthcare market are creating opportunities for companies that are striving to make profits in the sinusitis treatment market. Per the Center of Disease Control and Prevention (CDC)’s latest findings, 28.9 million adults in the United States get diagnosed with chronic sinusitis each year.

Considering the solid prospects of the market, we believe that Intersect ENT will gain strong market traction in the upcoming days.

<p class="canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm" type="text" content="Share Price Performance” data-reactid=”33″>Share Price Performance

Over the past six months, shares of Intersect ENT have underperformed the industry it belongs to. The stock has lost 37.4% against 2.2% rise of the industry.

<p class="canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm" type="text" content="Zacks Rank &amp; Key Picks” data-reactid=”35″>Zacks Rank & Key Picks

Currently, Intersect ENT carries a Zacks Rank #3 (Hold).

Some better-ranked stocks from the broader medical space are Aphria Inc. APHA, Hologic, Inc. HOLX and QIAGEN N.V. QGEN.

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