Dedicated CPT® code marks key commercialization milestone to open reimbursement for and adoption of NaviDKD® predictive diagnostic platform.
Journey Biosciences, a biotechnology innovator of predictive screenings, today announced that a dedicated CPT PLA code, 0384U, has been assigned for its flagship product, NaviDKD, by the American Medical Association (AMA). This milestone marks a significant step toward payer billing and payment, and enables broader adoption of the innovative predictive diagnostic platform.
Already clinically validated in major studies for both type 1 and type 2 diabetes, the CPT PLA code assignment removes a key barrier to accelerating commercialization of NaviDKD. Reimbursement largely contributes to the adoption of new healthcare technologies.
Using a proprietary algorithm, NaviDKD examines specific blood biomarkers and categorizes individuals into three unique risk groups, predicting their likelihood of developing kidney disease 10+ years into the future. With this predictive screening, patients can receive early clinical and lifestyle interventions that can delay or prevent the onset of kidney disease and provide major cost savings to commercial and public payers.
“The establishment of a dedicated CPT PLA code is an important milestone for us and plays a significant role in our commercialization strategy,” said Adam Graybill, CEO of Journey Biosciences. “Diabetes-related kidney disease is costly and complex to treat. The ability to bill insurance for NaviDKD creates a meaningful opportunity for the commercialization of our technology platform.”
In the US, one in three people with diabetes develops chronic kidney disease (CKD) and 90% of those affected don’t know they have it. Costs for treating CKD are rising, with Medicare spend reaching nearly $140 billion in 2020. With each stage of disease progression, costs increase exponentially. Early identification and intervention are essential to slowing or preventing disease progression and reducing healthcare expenditures. NaviDKD enables early clinical intervention by identifying risk before signs or symptoms appear and is positioned to significantly improve both economic and health outcomes.