EPS100Momentum's  Instablog

TranS1 Inc., a Delaware corporation (the "Company") has previously disclosed that healthcare providers rely on third-party payors, including private health insurance plans, to pay for all or a portion of the costs and fees associated with the Company's pre-sacral approach and AxiaLIF interbody fusion procedure. 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.
However, the Company has recently been informed that Humana Inc. ("Humana"), which is a major private health benefits company, has recently changed its spinal surgery reimbursement policy to include coverage for medically necessary interbody fusion procedures when using the Company's pre-sacral AxiaLIF approach. Humana will reimburse these procedures at the same level as other spinal interbody fusion surgeries for which it currently provides reimbursement. According to recent Humana public filings, it has approximately 10.1 million medical members and 7.0 million specialty members. To the Company's knowledge, this coverage decision for the pre-sacral approach to interbody fusion represents the first such decision by any health benefits company in the United States.