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Reimbursement Difficulties With TranS1's AxiaLIF and NuVasive's XLIF Have Sceptics Talking

Thursday, December 17, 2009 Health Insurance News J E 4
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WALTHAM, Mass., Dec. 16 According to Millennium Research Group (MRG), the global authority on medical technology market intelligence, although the US minimally invasive spinal fusion market will expand at a compound annual growth rate of over 12% through 2014, reimbursement concerns in certain segments will limit growth in the overall market, which previously had been forecast at almost 20%.

MRG's US Markets for Minimally Invasive Spine Technologies 2010 report finds that the complexity associated with the Category III reimbursement code for the TranS1 Axial Lumbar Interbody Fusion (AxiaLIF) procedure has made it difficult for some surgeons to receive full reimbursement. As a result, some surgeons have limited their use of the technique in their practice, and some have been prevented from adopting the procedure at all. Although reimbursement issues limited AxiaLIF procedure growth in 2009, TranS1 has already begun to combat the issue with increased education to both current and future clients to minimize reimbursement problems.

Similarly, in 2008 and 2009, NuVasive's eXtreme Lateral Interbody Fusion (XLIF) procedure was deemed experimental and denied reimbursement by major insurance providers Aetna, Cigna, and UnitedHealth Group in the US. The procedure, which is currently reimbursed by the Centers for Medicare and Medicaid Services (CMS) and other insurance providers under the anterior approach, will continue to receive nationwide reimbursement; however, these unfavorable decisions have industry insiders questioning whether other private insurance providers will soon follow suit.

"Growth of the lateral fusion market will definitely be hampered by the lack of coverage from these three private insurers, which cover over 100 million people in the US," says Deanna Vankessel, Analyst at MRG. "Instead of performing an XLIF, some surgeons will employ other minimally invasive approaches, such as percutaneous transforaminal or posterior techniques; however, the presence of nationwide CMS coverage for the XLIF and the continued release of favorable clinical data demonstrating its efficacy will curb the negative impact of these insurance providers' decisions."

MRG's new report, US Markets for Minimally Invasive Spine Technologies 2010, serves as a tool for evaluating the performance of the minimally invasive spine technology market from 2008 to 2014. The report provides critical insight into trends that will fuel market growth for minimally invasive spinal fusion, facet fixation device, intradiscal therapy, and discography device markets. With detailed analysis of procedures, average selling prices, units, average selling prices, revenues, and competitive dynamics this report will allow readers to trace current and emerging market trends, identify opportunities, and track competitors.

About Millennium Research Group

Millennium Research Group (www.MRG.net), a Decision Resources, Inc. company (www.DecisionResourcesInc.com), is the global authority on medical technology market intelligence and the leading provider of strategic information to the healthcare sector. The company provides specialized industry expertise through multiclient market research, ongoing Marketrack(TM) projects, customer loyalty tracking, facility-level procedure forecasting, and customized solutions.

About Decision Resources, Inc.

Decision Resources, Inc. is a cohesive portfolio of companies that offers best-in-class, high-value information, and insights on important sectors of the healthcare industry. Clients rely on this analysis and data to make informed decisions. Please visit Decision Resources, Inc. at www.DecisionResourcesInc.com.

All company, brand, or product names contained in this document may be trademarks or registered trademarks of their respective holders.

For more information, contact: Amy Krohn Millennium Research Group 416-364-7776 ext. 101 akrohn@mrg.net Elizabeth Marshall Decision Resources, Inc. 781-296-2563 emarshall@dresources.com

SOURCE Millennium Research Group
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BAP58
Wow, so sad to hear this great new Axialif procedure that has completly cured my broken back a year ago with absolutly no pain or instability and has given me my competitive tennis career back is now being snubbed by providers for reinbursment, I would equate this to someone discovering a cure for diabeties and then being told it was just not needed!.... Somebody needs to shake up Providers and State Insurance Commissioner's. I'm mad as Hell...... It needs to be about about whats best for patients with debilitating spine problems, and not about keeping the old school in the pink! B
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