A modified albumin point-of-care test for ruling out heart attacks likely will receive similar reimbursement to the $47 rate for B-type natriuretic peptide tests, according to Charles Root, president of consulting firm MCF Compliance.

"Probably the reimbursement will be 'cross-walked' to a similar value" as BNP, Root noted during the American Association for Clinical Chemistry's three-part, point-of-care testing audioconference March 19.

Ischemia Technologies received 510(k) clearance Feb. 14 for its albumin cobalt binding ( ACB ) test for use with troponin protein tests and an ECG to help rule out heart attacks (¹ Also see "ITI Test To Help Rule Out Heart Attacks Has $180 Mil. U.S. Market Potential" - Medtech Insight, 24 February, 2003., p. 17). Calling the $47 reimbursement rate for BNP tests under the 2003 laboratory fee schedule a "major success," Root noted reimbursement for older cardiac marker tests ranges between $11-18. Approved BNP tests for congestive heart failure include Biosite's Triage BNP and Roche's NT-proBNP tests (² Also see "Roche CHF Test Will Benefit From Reimbursement Advantages In 2003" - Medtech Insight, 25 November, 2002., p. 23).

Root also predicted that CMS will begin to reimburse home-use tests under the physician fee schedule, as it did with home prothrombin time testing, instead of as durable medical equipment for home health care. Payment under the physician fee schedule forces physicians to be involved in patient care and takes into account new technologies that use disposable tests instead of DME, he noted. "Most of the coverage for new tests will probably follow this same pattern."

Also during the meeting, Chris Fetters, president of consulting firm Nextivity, urged POC coordinators to utilize bar coding. "You know how bad your patient IDs are.... [Bar coding] is the best service you can perform for reducing medical errors at your hospital," Fetters advised.

Fetters and Root also encouraged laboratories to bill for POC tests used in inpatient care because those tests "end up on cost reports, which dictate the exact amount of your DRG payments," Root noted.

AACC's annual POC testing conference, sponsored by Bayer Diagnostics, ABX Diagnostics and ITC, is aimed at educating laboratorians on how to maximize POC testing reimbursement and ease billing procedures, as well as providing updates on technology development. Two remaining sessions will be held on March 26 and April 2.

ACB Cardiac Marker May Receive Same Reimbursement Rate As BNP – Root

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