Bausch + Lomb Corporation announced that the American Medical Association (AMA) has assigned XIPERE (triamcinolone acetonide injectable suspension) a Category I Current Procedural Terminology (CPT) code.
Refresh me on XIPERE.
Approved by the FDA in October 2021, XIPERE is a corticosteroid indicated for the treatment of macular edema associated with uveitis. It became commercially available in the U.S. in March 2022.
Per its prescribing info, the medication has a recommended dosage of 4 mg which is administered as a suprachoroidal injection.
What makes it unique?
XIPERE is currently the first and only therapy in the U.S. that incorporates a surgical approach utilizing the suprachoroidal space with the SCS Microinjector (Clearside Biomedical) for the treatment of macular edema associated with uveitis.
Gotcha. Now explain CPT codes.
First things first: CPT codes are a national coding set for healthcare professional services such as in-office visits, diagnostic technologies, injection administration (J-Codes, see below for more detail), telemedicine, minor procedures, and surgery (whether in-office, hospital or ambulatory surgery center [ASC]).
Per the AMA*, three types exist:
- Category I: Generally ordered into sub-categories based on procedure/service type and anatomy.
- Category II: Supplemental codes used for performance measurement (optional use).
- Category III: Temporary for new and developing technology, procedures (for those not meeting Category I criteria) and services.
*A recently-added fourth category—Proprietary Laboratory Analyses (PLA)—are used for proprietary clinical laboratory analyses.
And in this case?
With support from the American Academy of Ophthalmology (AAO) and the American Society of Retina Specialists (ASRS), the AMA granted XIPERE the CPT code 7516.
As mentioned, XIPERE’s code is Category I.
So when will this be official?
January 1, 2024.
Has XIPERE been granted any other codes?
Yes, actually. The medication was previously granted the J-Code of J3299 in July 2022.
Read here for a refresh on J-Codes.