ADA establishes reimbursement code for Exparel: 3 things to know


Alongside CMS's recent reimbursement code for Exparel in ambulatory surgery centers, the American Dental Association created a separate D-code to reimburse Exparel.

To learn more about recent payment updates as well as billing and coding for Exparel, register for this webinar titled "CMS Reimburses Non-Opioid Postsurgical Pain Management in the ASC: Review of the New CMS Rules and Opportunity for ASCs" on Dec. 4, from 12:00 p.m. to 1:00 p.m.

Here are three things to know:

1. Dentists and dental service organizations will need to use the product-specific billing code D9613, which will provide payment for Exparel infiltration in oral surgery procedures.

2. The code will be effective Jan. 1, 2019. Since its launch in 2012, more than four million patients have been treated with Exparel in the U.S.

3. Exaprel is indicated for single-dose infiltration in adults to produce postsurgical local analgesia and as an interscalene brachial plexus nerve block to produce postsurgical regional analgesia.

"We are pleased to receive separate reimbursement from Medicare in the ASC," said Pacira CEO Dave Stack. "We believe these developments will significantly simplify the reimbursement process for clinicians and facilities utilizing the product, thus improving patient access and accelerating the transition of certain procedures to the ambulatory surgical center setting."

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