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Auxilium Pharmaceuticals, Inc. Announces Publication of U.S. CPT® Codes and Related Reimbursement Rates for XIAFLEX®
Date:11/2/2011

the codes in 1966.

Among the AMA's stated criteria for a new Category I CPT code are requirements that: (1) the service/procedure has received approval from the U.S. Food and Drug Administration for the specific use of devices or drugs; (2) the service/procedure is a distinct service performed by many physicians/practitioners across the U.S.; (3) the clinical efficacy of the service/procedure is well established and documented in U.S. peer review literature; and (4) the service/procedure is neither a fragmentation of an existing procedure/service nor currently reportable by one or more existing codes.

"We are extremely pleased that the AMA has created unique CPT codes to validate the value of the XIAFLEX injection and manipulation procedures.  These two new codes, along with existing evaluation and management and splinting codes, should ease the claims processing burden on office staff, speed up the time to payment and increase predictability of payment," said Armando Anido, Chief Executive Officer and President of Auxilium.  "We plan to smooth the 2012 transition to new XIAFLEX procedure codes with education for physician offices starting in late 2011."

2012 CPT codes for XIAFLEXThe below codes represent what the Company expects will be the typical treatment cycle (evaluation & management visit, injection procedure, manipulation procedure and splinting) of a new Dupuytren's patient who eventually receives a single XIAFLEX injection in a Dupuytren's cord.  These 2012 rates reflect a national Medicare average of the non-facility allowable.  As always, coding reflects clinical decisions, and physicians may opt to use other or additional codes based on their medical judgment.

Table 1 – XIAFLEX Procedure Reimbursement per Single Injection – Medicare National AverageDescription

Code

Amount Office or other outpatient visit, for the evaluation and management of a new patient

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SOURCE Auxilium Pharmaceuticals, Inc.
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