to detect this condition. It runs a low-frequency electric current through the body. Based on the speed of the current going through tissues and fluids, the machine can see how much impedence the fluid is encountering (hence the name ImpediMed). This data produces a readout that can tell whether the fluid is draining properly, or whether a patient has telltale signs of lymphedema, he says.
ImpediMed has two of these devices approved by the FDA, including one that got approved in October. One of them, the L-Dex U400, is offered free to the physicians’ office. ImpediMed then sells disposable electrodes for each procedure for $25 to $45 each, and doctors can pocket a $150 to $300 reimbursement from insurers, Smith says. Clearly, ImpediMed has thought long and hard about how to pencil out the pricing so that doctors see it’s in their financial interest to prescribe the test. “Getting the reimbursement right is as important as getting the technology right,” Smith says.
The Centers for Medicare and Medicaid Services would like to see some validation from doctors before they establish reimbursement for the test with a specific code, so ImpediMed has been trying to impress the American Society of Breast Surgeons for its stamp of approval. Right now, many doctors are getting reimbursed by insurance companies like Aetna, or Blue Cross/Blue Shield through miscellaneous codes set by the Medicare agency, but that creates a little more hassle for the doctors because they have to explain the procedure, Smith says.
This doesn’t sound like an easy sell to get doctors on board. “Some of these guys say ‘I never see it in my practice,'” Smith says. “There is a segment that thinks it’s not a problem. It’s an indictment of their surgery,” he says.
Besides lining up its technical, and economic arguments, ImpediMed is also trying to put some grassroots pressure on the doctors. The company is reaching out to some celebrities—they won’t say who—but ImpediMed hopes a spokesperson might raise awareness of lymphedema among the targeted demographic of middle-aged women with breast cancer. No celebrity has signed up yet, but clearly if enough women start asking their doctors about this test, some will probably be persuaded to offer it.
“Women are terrified of lymphedema,” Smith says. “It’s important for them to be able to know they don’t have it, or to catch it early.”
