TranS1 Inc. (NSDQ:TSON) confirmed that Horizon Blue Cross Blue Shield of New Jersey will cover its AxiaLIF spinal surgery procedure, according to a regulatory filing, sending its stock price up nearly 2 percent today.
Wilmington, N.C.-based TranS1 said the health insurance provider will cover AxiaLIF procedures deemed “medically necessary” using existing billing codes.
“Historically, there has been a lack of consistent reimbursement for the specific CPT code (used to describe specific services performed by physicians when submitting reimbursement claims) used to describe the AxiaLIF interbody fusion surgery, such that some physicians have found it difficult to obtain reimbursement for the procedure,” according to the filing. “The company has confirmed with Horizon that CPT codes 0195T and 0196T, which are the CPT codes associated with the company’s pre-sacral AxiaLIF procedure, will be deemed eligible for coverage when the medical necessity fusion criteria set forth in the policy are met.”
That opens up TranS1’s interbody fusion procedure to a patient pool of about 3.6 million, the company said. Horizon is the second insurance carrier to initiate coverage of the AxiaLIF system.
The news sent TSON shares on a modest recovery from their plunge earlier this week. Shares lost 68.6 percent Oct. 18 after TranS1 disclosed a subpoena by the U.S. Dept. of Health & Human Services for documents in a probe of its marketing practices, falling from their $3.12 close Oct. 17 to finish the next day at $1.85.
TSON shares were trading at $1.90 as of about 2:40 p.m. today, up 1.6 percent.