PROCEDURE
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WHAT IS THE VIA DISC NP PROCEDURE?
The VIA Disc NP procedure is a minimally invasive procedure intended for patients who have experienced tissue loss within the lumbar intervertebral discs. The procedure involves fluoroscopy imaging to guide a spinal needle through Kambin’s safe triangle into the nucleus pulposus of the intervertebral disc. The VIA Disc NP allograft is delivered into the target disc to rehydrate and support the cushioning function of the degenerated disc.
REIMBURSEMENT SUPPORT
The VIA Disc NP team is committed to working alongside patients and physicians to support all aspects of the reimbursement process. The VIA Disc NP procedure is a minimally invasive, outpatient procedure usually performed in either a hospital outpatient department (HOPD) or an ambulatory surgery center (ASC). Two Category III CPT codes, 0627T and 0629T, have been established by the Centers for Medicare and Medicaid (CMS) for the procedure. The codes are assigned to APC 5115 with a J8 device intensive payment indicator.1
PATIENT ACCESS PROGRAM
VIVEX provides an easy-to-navigate patient access program to help patients obtain prior authorization and approval for payment for the procedure. Once a provider has determined medical necessity to perform the VIA Disc NP procedure, the patient access program will provide the following:
- Secure online portal for prior authorization and appeal requests
- Electronic benefits verification
- Prior authorization and appeal submissions
- Real-time case updates and communication
- Access to reimbursement tools
- Coverage policy and payer landscape information
The primary goal of the VIA Disc NP Patient Access Program is to help patients take control of the process and provide full transparency to patients and providers alike.
Customers using VIA DISC NP can contact VIVEX Reimbursement Support at 877.475.0888 or reimbursement@vivex.com.
VIVEX has used reasonable efforts to provide accurate information herein, but this information should not be construed as providing clinical advice, dictating reimbursement policy, guaranteeing coverage, or as a substitute for the judgment of a health care provider. It is always the health care provider’s responsibility to determine the appropriate codes, charges for services, and use of modifiers for services rendered and to verify coverage with payers, including the applicability of any non-coverage policies that may exist. Reimbursement laws, regulations, and payer policies change frequently without notice, and VIVEX assumes no responsibility for the timeliness, accuracy, or completeness of the information provided. It is highly recommended that health care providers consult with their payers, coding specialists, and/or legal counsel regarding coverage, coding, and payment issues
1. CPT Copyright 2021 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.
