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

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Intersect ENT, Inc. (XENT - Free Report) 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.

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.

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.

Sinuva’s J-Code Related Progress So Far

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.

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.

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.

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. , Hologic, Inc. (HOLX - Free Report) and QIAGEN N.V. (QGEN - Free Report) .

Aphria’s long-term earnings growth rate is projected at 24.6%. It currently carries a Zacks Rank #2 (Buy). You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.

Hologic’s long-term earnings growth rate is estimated at 7%. The company presently has a Zacks Rank #2.

QIAGEN’s long-term earnings growth rate is estimated at 12.2%. It currently sports a Zacks Rank #1.

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