Ask Dr. Z

Our EP physicians would like to begin using AIGISRx anti-bacterial envelope when inserting PMs and ICDs.

I am responsible for the facility billing. AIGISRx is an anti-bacterial envelope made from knitted polypropylene mesh substrate, coated with a polyarylate bioresorbable polymer containing two antimicrobial antibiotics, minocycline and rifampin. AIGISRx is a dual component (resorbable and non-resorbable), sterile prosthesis designed to reduce infection and to stabilize the implantable PM or ICD when implanted in the body.

I have been notified by the manufacturer that they have "confirmed that using the CMS A4649-surgical supplies & devices-other implants, will allow for full reimbursement of the AIGIS anti-bacterial envelope ... this is a great first step toward CMS issuing a CPT code specifically for this type of device ... now we can say that this will not increase the cost of the procedure."

1. Do you agree, per OPPS 2009 Final Rule, there are no devices eligible for pass-through payment for 2009, and therefore, there would be no additional reimbursement, and the device would be unconditionally packaged into the reimbursement of the Insertion of the PM or ICD, whichever is performed.
2. Do you agree using this device will increase the cost of the procedure.
3. Would A4649 be the most appropriate HCPCS code to use with Revenue Code 0278?

Thank you.