CMS increases NLA for T-SPOT.TB test's CPT code 86481
Published on January 10, 2012 at 4:43 AM
Oxford Immunotec, Inc. announces that, following a reconsideration request made by the company, the Centers for Medicare and Medicaid Services has increased the national limitation amount (NLA) for the Current Procedural Terminology (CPT®) code 86481 which is used for the T-SPOT.TB test. Effective January 1, 2012 the new NLA for 86481 is $106.12, an increase of $18.90 over the previous reimbursement amount of $87.22.
The T-SPOT.TB test is a blood test for tuberculosis (TB) infection and is based on a patented enzyme-linked immunospot (ELISpot) technology which is a highly accurate and innovative way to measure T-cell response. The T-SPOT.TB test measures the patient's immune response to T-cells that have been sensitized to Mycobacterium tuberculosis, the bacterium that causes tuberculosis infection.
The T-SPOT.TB test is also known as an Interferon Gamma Release Assay (IGRA). The introduction of IGRAs provides healthcare institutions with a key tool in eradicating TB in the United States. The Centers for Disease Control (CDC) recommend that IGRAs can be used in all situations where the tuberculin skin test (TST) is currently used. The T-SPOT.TB test has become widely utilized in hundreds of hospitals, medical practices and public health facilities throughout the United States.
Commenting on the change in the NLA, Dr. Peter Wrighton-Smith, CEO of Oxford Immunotec, said, "Our reconsideration request was made on the basis that the T-SPOT.TB test has methodological differences to the other IGRA which merit additional reimbursement. I am pleased that CMS reconsidered the national limitation amount for 86481 and has recognized the important methodological differences in our T-SPOT technology."