Advocacy Opportunity: Adding UDI to Claims Data

November 30, 2022

3 minute read

Did you ever stop to think about how many items we scan these days - groceries, boarding passes, passports? The first scanned product was a 10-pack of Wrigley's Juicy Fruit gum using a universal product code (UPC) as a standard item identifier in a retail store. Since then, linking scanned products to consumers has transformed how organizations track purchases, optimize workflows, increase revenues, and develop new items or services.

One crucial area where we do not routinely scan, where we do not insist on the use of standard Unique Device Identifiers (UDIs), is the healthcare claim - the request for payment that a consumer or healthcare provider submits to an insurer to pay for covered items or services. UDI was introduced as a Federally required barcode/identifier in 2013 (see June 2020 Symmetric blog for more details about UDI). The UDI barcode is now on the label of over 3.7 million device models, representing hundreds of millions of products, and linked to an open FDA data source - AccessGUDID. Hospitals are adopting UDI, health IT vendors are incorporating UDI data into their supply chain, clinical, and registry applications, but we are not at the tipping point of seeing UDI used to scan and link patients to the devices used in medical procedures.

Unlike UPC, the UDI is not yet included in the claims software that transmits charges and receives payments. Providers and patients file claims to obtain reimbursement from a payer like the Center for Medicare and Medicaid Services (CMS) or a private insurance company. This claims data is relied upon to manage costs and and revenues, monitor procedure and other resource usage, and evaluate patient care. Healthcare experts believe that linking the capture of UDI to the additional information captured in claims, especially for implants, will be a game changer for incentivizing hospitals to scan and make more widespread use of UDI.

On January 18-19 2023, the National Committee for Vital and Health Statistics (NCVHS) will hear public comments on whether UDI would be a valuable addition to healthcare claims. Following the hearing NCVHS will make recommendations to CMS on whether to include UDI in regulations calling for the update of X12, the standard used by software vendors to transmit claims data. Until December 15th, NCVHS is requesting written public comments as described in this recent announcement.

Symmetric Health Solutions believes in a world based upon data transparency. Including UDI in claims data is a major step that aligns with our mission to provide the most accurate, comprehensive, and timely healthcare information. If you believe that it is important to better understand device usage and patient outcomes at the product level, we encourage you to read and provide your comments to NCVHS.

Terrie Reed

Symmetric Chief Strategy Officer

(Former FDA CDRH Senior Advisor for UDI Adoption in Electronic Health Information)