Iridex Corporation Announces Successful Appeal for Revision of Recent Medicare LCDs to Provide Broader Coverage of Cyclophotocoagulation
November 27 2023 - 8:00AM
Iridex Corporation (NASDAQ: IRIX), a worldwide leader providing
innovative and versatile laser-based medical systems, delivery
devices, and procedure probes for the treatment of glaucoma and
retinal diseases, today announced its successful advocacy for
revision of the recently issued Medicare Local Coverage
Determinations (LCDs) for Cyclophotocoagulation (CPC).
During the last few days, the five Medicare Administrative
Contractors (MACs) that issued the new LCDs have all corrected
errors in criteria for coverage of CPC resulting in significantly
broader patient qualification in the jurisdictions of these
MACs.
”We appreciate the MACs quick action, before the Effective Date
of the coverage change, to assure broader patient access to the
benefits of CPC,” said David Bruce, Iridex President and CEO, “and
that this correction was supported by strong advocacy from the
original authors of the 2001 paper cited by the MACs in setting the
new coverage criteria, led by Dr. Shan Lin from the Glaucoma Center
of San Francisco.”
The change in criteria better aligns the LCDs with the
conclusions and recommendations made by the authors of the 2001
paper, “Cyclophotocoagulation, A Report by the American Academy of
Ophthalmology (AAO),” by mirroring several of the recommended
indications. Specifically, the list of patient characteristics used
in the criteria, which had been separated by the word “AND,” are
corrected to be separated by the word “OR” and read as follows:
“4. Cyclophotocoagulation will be considered medically
reasonable and necessary for patients with refractory glaucoma
when:a. Have failed trabeculectomy or tube shunt procedures, ORb.
Minimal useful vision and elevated intraocular pressure, ORc. Have
no visual potential and need pain relief.”
Mr. Bruce continued, “While we are pleased with this initial
coverage-enhancing step, we are preparing a subsequent appeal to
further broaden the patient criteria qualifying for reimbursement
in these MAC jurisdictions. We will urge MAC administrators to
include the additional recommendations from the 2001 AAO paper that
remain excluded from the current modified LCD to cover (i) patients
that are poor candidates for invasive surgical procedures and (ii)
emergency situations. Our appeal will also seek proper
consideration of the technological advances and the large body of
peer-reviewed clinical studies supporting a broad range of patient
types, disease severities, and safety evidence for CPC during the
22 years since the AAO paper and further broaden patient
indications for coverage.”
About Iridex Corporation
Iridex Corporation is a worldwide leader in developing,
manufacturing, and marketing innovative and versatile laser-based
medical systems, delivery devices and consumable instrumentation
for the ophthalmology market. The Company’s proprietary MicroPulse®
technology delivers a differentiated treatment that provides safe,
effective, and proven treatment for targeted sight-threatening eye
conditions. Iridex’s current product line is used for the treatment
of glaucoma and diabetic macular edema (DME) and other retinal
diseases. Iridex products are sold in the United States through a
direct sales force and internationally primarily through a network
of independent distributors into more than 100 countries. For
further information, visit the Iridex website at
www.iridex.com.
Safe Harbor Statement
This announcement contains forward-looking statements within the
meaning of Section 27A of the Securities Act of 1933, as amended,
and Section 21E of the Securities Act of 1934, as amended,
including those statements concerning clinical expectations and
commercial trends, market adoption and expansion, demand for and
utilization of the Company's products and results and expected
sales volumes. These statements are not guarantees of future
performance and actual results may differ materially from those
described in these forward-looking statements as a result of a
number of factors. Please see a detailed description of these and
other risks contained in our Quarterly Report on Form 10-Q filed
with the Securities and Exchange Commission on November 20, 2023.
Forward-looking statements contained in this announcement are made
as of this date and will not be updated.
Investor Relations ContactPhilip
TaylorGilmartin Groupinvestors@iridex.com
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