Advisory Panel Recommends including DIs on Claims Forms

February 2017 ~

Since the start of the UDI system, providers, payers and patient advocates have called for the trackable IDs to be included on claims forms to help the industry more quickly identify dangerous devices and better evaluate outcome data.

The HHS Office of Inspector General (OIG) reported in October 2016 that Medicare paid $1.5 billion to treat patients implanted with seven faulty cardiac devices, stating “Our preliminary results show that there is a significant impediment to readily identifying Medicare’s total costs caused by a medical device recall, a device that prematurely failed, or a necessary device upgrade.”

It was recommended that CMS work with the Accredited Standards Committee X12 (ASC X12) an insurer standards committee, to include DIs in for implants on the next claim forms as they would “assist in identifying the costs to Medicare for recalled or defective medical devices, help ensure patient safety, and safeguard Medicare trust funds.”

ASC X12 recommended device identifiers (DIs) be included on medical claims forms when a “high-risk implantable device” is implanted or removed. The recommendation says that the UDI should be included when the provider and payer have mutually agreed or are mandated by law to exchange the information when a device is implanted.

According to a Pew Charitable Trusts report, the move will be a “critical first step” toward aiding regulators, providers and patients to monitor the long-term safety of cardiac stents, artificial hips, pacemakers, among other medical implants.

Source(s): Pew Charitable Trusts, February 2017; Modern Healthcare, February 2017; HealthcareDIVE, February 2017;