Medtronic Applies for New CMS Reimbursement Code for Artificial Pancreas

Medtronic's Diabetes segment has applied for a new reimbursement code. The application, filed with the Centers for Medicare and Medicaid Services (CMS), comes after FDA approval for the company's MiniMed 530G with Enlite.The MiniMed 530G with Enlite received approval under the FDA's new category, dubbed "OZO: Artificial Pancreas Device System, Threshold Suspend." The novel device comprises a continuous glucose monitor and an insulin pump. Thee devie can automatically suspend the delivery of insulin for up to 120 minutes when the included sensor reaches a predetermined level. However, this mode will only be activated when a patient doesn't respond to the alarm on the device."We have applied for a new code with CMS for sensor-augmented pumps. We will evaluateadditional reimbursement codes based on this new category of devices," noted a spokesperson for Medtronic.As of now, diabetic patients who receive coverage through Medicare are not covered for continuous glucose meters. However, that could change in the near future.According to Medtronic, the device's new Enlite sensor boasts higher accuracy, a smaller size and improved comfort. In addition, the device can detect hypoglycemia episodes with an accuracy of 93%.Among payers, reimbursement is still up in the air. While some payers indicate that the novel systems would be evaluated as a combination of component parts, other payers may view the systems as a completely new technology."At Medtronic, our goal is to develop a fully automated artificial pancreas system for people with diabetes so that they can spend less time thinking about diabetes and more time living their lives," noted a Medtronic spokesperson. "However, this type of technology is not going to happen all at once. Instead, we plan to take an iterative approach, introducing automation with each step toward a fully automated system."