Reimbursement & Coding



Protecting reimbursement and coverage




At CSI, our commitment to patients, physicians and hospitals doesn’t end with delivering unique technology. Our team collaborates with leading experts and encourages policy organizations to support patient access and appropriate reimbursement for high-quality interventional treatments for PAD and CAD.

CSI is a leader in advocating for the introduction and the continuance of Medicare reimbursement codes for treatment of vascular disease. We continually work with The Centers for Medicare and Medicaid Services (CMS) to introduce new codes to keep up with new technology and provide fair payments for relevant value-based codes.

We are currently working with CMS and elected representatives to establish Medicare coverage to mandate PAD screenings for at-risk beneficiaries and other initiatives to reduce racial disparities in treatment access. Learn more about our Healthcare Policy initiatives.

Through regulatory and legislative efforts now and in the future, CSI works to deliver on our promise to support physicians and hospitals.


Coding and Payment Reference Guide

For your reference, we’ve included coding and payment information for percutaneous coronary intervention (PCI) and revascularization procedures. These procedures include those that utilize the Diamondback 360® Coronary and Peripheral Atherectomy Systems. Our reimbursement guides contain information for both coronary and peripheral procedures.


Please note: Reimbursement information provided by CSI is gathered from 3rd party sources and is presented for illustrative purposes only. This information does not constitute legal or reimbursement advice. CSI makes no representation or warranty regarding this information or its completeness, accuracy, timeliness or applicability with any particular patient. CSI specifically disclaims liability or responsibility for the results or consequences of any actions taken in reliance on information in this document. CSI encourages providers to submit accurate and appropriate claims for services. Laws, regulations and payer policies concerning reimbursement are complex and change frequently. Providers are responsible for making appropriate decisions related to coding and reimbursement submissions. Accordingly, CSI recommends that customers consult with their payers, reimbursement specialists and/or legal counsel regarding coding, coverage and reimbursement matters.

Reimbursement Support

We can provide reimbursement support for your organization.
Contact us with questions or if you require assistance in your analysis.

Our team can assist you with:

  • Reimbursement and Coding Information
  • Economic Modeling

We are available to help healthcare providers understand reimbursement, coding and use of our reimbursement information for CSI products.


Questions?

Contact our Reimbursement Hotline at 844-222-7234
or contact your CSI representative.

Don’t have a rep?



Supporting Value-based Technology

The CSI team is committed to assisting healthcare policymakers and healthcare providers in evaluating the economic impact of utilizing orbital atherectomy technology. 




Economic Evidence

Analysis of cost-effectiveness of treatment with orbital atherectomy

  • ORBIT II Economic Evidence
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    ORBIT II10 Cost-Effectiveness Analysis The analysis model looked to determine the cost-effectiveness of using the Diamondback 360® Coronary Orbital Atherectomy System (OAS), compared to Medicare data and patients in the HORIZONS-AMI and ACUITY trials, in the treatment of de novo, severely calcified lesions. Key Takeaways The ORBIT II mean index procedure costs were 17% lower, approximately $2,700 Estimated mean revascularization costs were lower by $1,240 in the base case The cost offsets in the first year, on average, fully cover the cost of the device with an additional 1.2% cost savings The study presents low-value and high-value scenarios and concludes that in even the most pessimistic scenario, OAS offers good value with a cost per life-year gained of $11,895 For PCI patients with severely calcified coronary lesions, OAS technology is likely to result in lower inpatient costs, particularly for the initial procedure and first 30 days Study Design 297 patients ≥65 years from the ORBIT II trial of 443 patients Indirectly compared to Medicare data of similar patients (n=308) using observational data for index procedure For revascularization and cardiac death in the following year, used a pooled analysis of the HORIZONS-AMI and ACUITY trials Primary objective: assess the potential cost-effectiveness of the Diamondback 360 OAS for severe coronary artery calcification by modeling: Expected cost offsets during the acute and post-acute care periods Potential reduction in patient mortality and morbidity The comparison of mortality and morbidity impacts relating to the overall cost impact of device use  
  • CONFIRM Series Economic Evidence
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    The CONFIRM registry series is a database of patients with peripheral artery disease (PAD) who were treated with orbital atherectomy in both office-based laboratories (OBLs) and hospital settings. Statistical analyses assessed the outcomes of atherectomies performed in OBL compared to hospitals. Key Takeaways Final residual stenosis after adjunctive therapy was 10%±11% in the hospital group and 11±17% in the OBL group Dissections occurred in 11.4% of the lesions in the hospital group vs. 6.5% in the OBL group Adjusted logistic regressions showed no difference in any individual or overall complication rate Orbital atherectomy treatment of PAD in an OBL was found comparable to treatment in a hospital setting Study Design Procedural data collected for 3,135 PAD patients at 212 sites in the US treated with OAS for at least one lesion Statistical analyses included Student t test for continuous measures, Chi-square test for categorical measures and logistic regression for complication rates Designed to assess the procedural outcomes of atherectomy in the OBL setting
  • COMPLIANCE 360º Economic Evidence
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    The clinical outcomes from COMPLIANCE 360º5 – a prospective, multicenter, randomized pilot study comparing Diamondback 360® Peripheral Orbital Atherectomy System (OAS) + balloon angioplasty (BA) vs. BA alone for treatment of calcified femoropopliteal lesions – were correlated with cost data and published quality of life data. Key Takeaways Stent utilization was higher with BA-alone treatment for all patients Stent placement effects subsequent procedures and increases the costs for reintervention, while limiting future treatment options The 1-year incremental cost of OAS+BA vs. BA alone was USD $549, resulting in an incremental cost-effectiveness ratio (ICER) of USD $3,441 Study Design Utilized data from COMPLIANCE 360º study subjects from nine US centers Study subjects who met all inclusion criteria and no exclusion criteria were equally randomized into the two study arms, one for OAS followed by BA and one for BA alone Key inclusion criterion: Rutherford Class  2-4 patients who had de novo lesions of ≥70% stenosis and fluoroscopically visible calcium Analyzed OAS+BA and BA-alone procedure charges, procedure time, length of stay, and stent and balloon utilization Utilized uniform billing statements (UB-04s) for hospital charges, site of service and associated medical resource utilization (MRU) Constructed a decision tree based on procedural success and outcomes through 1 year with endpoints of patency, target lesion revascularization or target vessel revascularization, and claudication with no subsequent treatment Patient Population: OAS+BA study arm: 25 subjects with 38 lesions (17 outpatient and 8 inpatient procedures) BA-alone study arm: 25 subjects with 27 lesions (19 outpatient and 6 inpatient procedures)

Professional Education


CSIQ® is the official professional education program of Cardiovascular Systems, Inc. Our goal is for you to use this information to better understand the prevalence of arterial calcium and how to treat it using our Orbital Atherectomy Systems. From group courses taught by leading orbital atherectomy experts to personalized, one-on-one proctorships, CSIQ® demonstrates the value and procedural efficiency of our Orbital Atherectomy Systems. Clinical data that underscore the safety, efficacy and long-term durability of the devices is also provided.