Expanding Your Continuum of Care Percutaneous Neurostimulation for the Treatment of Pain

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1 Expanding Your Continuum of Care Percutaneous Neurostimulation for the Treatment of Pain

2 Overview Page 2 BiowavePENS Expanding the Continuum of Care BIOWAVE

3 How Biowave Works BiowavePENS uses patented electrical signals to stop the transmission of pain signals to the brain. C-Fiber Before Na + in K + out Na + in K + out Pain Impulse After Biowave Active Electrical Field BiowavePENS utilizes a patented electrical signal technology in combination with a patented, percutaneous needle electrode array to deliver high frequency electrical signals into deep tissue encompassing the pain site. Polarized structures including the C-fiber and A-delta fiber cause the high frequency signals to multiply together resulting in the formation of a therapeutic, low frequency active electrical field in a 3.5 diameter hemisphere, (the size of half of a grapefruit), beneath each percutaneous electrode Pain Impulse Blocked The Active low frequency electrical field hyperpolarizes the C-fibers inhibiting action potential propagation, blocking the transmission of chronic, acute or postoperative musculoskeletal pai n signals to the brain. In addition, the low frequency electrical field induces hypoesthesia in the region of the pain site. Page 3 BiowavePENS Expanding the Continuum of Care BIOWAVE

4 BiowavePENS is Superior to TENS PENS Percutaneous Electrical Nerve Stimulation Transmits high frequency stimulation beneath the surface of skin) directly to pain nerve fibers blocking the transmission of pain signals to the brain (Frequency Conduction Block Theory) 1 TENS Transcutaneous Electrical Nerve Stimulation Transmits low frequency stimulation transcutaneously (across the surface of skin) which may act as a distraction (Gate Control Theory) Percutaneous Electrode Arrays Skin TENS Electrodes Signal Transmission Across Skin Surface Location of Pain on Nociceptive Pain Fibers Cross Section of Body Biowave Active Electrical Field Location of Pain on Nociceptive Pain Fibers Cross Section of Body Skin BiowavePENS vs. TENS BiowavePENS TENS Provides Long Lasting Pain Relief (Up to 72 Hours) Post Treatment 2 Proven to Reduce Opioid Use 1,2 Treatment Provides a Deep, Smooth, Comfortable Sensation 1,2 Easy to Use - No Programming 1 Randomized Blinded Controlled Study Treating OA Knee Patients Rush Univ. Medical Center - Published in ORTHOPEDICS June Randomized Controlled Study on the treatment of post-operative pain from TKA surgery - Hospital for Special Surgery, New York City Page 4 BiowavePENS Expanding the Continuum of Care BIOWAVE

5 Continuum of Care Chronic Back Pain: Cervical, Thoracic or Lumbar TIER 1 Pain Therapies Cognitive & Behavioral Modifications NSAIDs and other OTC Pain Medications TENS Biofeedback TIER 2 Pain Therapies Systemic Opioids Corticosteroid Injections Nerve Blocks Radio Frequency Ablation Physical Therapy 93%* of patients stop the continuum after Tier 2 therapy TIER 3 Pain Therapies Surgery Implanted Drug Pump Spinal Cord Stimulation (SCS) Page 5 BiowavePENS Expanding the Continuum of Care BIOWAVE

6 Continuum of Care Chronic Back Pain: Cervical, Thoracic or Lumbar Biowave is used as a diagnostic tool to predict the likelihood of success of an implanted spinal cord or peripheral nerve stimulator. In some cases continued treatment with BiowaveHOME may be the next course therapy. 93% are candidates for biowavepens 75% of patients respond positively to BiowavePENS neurostimulation Following a positive treatment response patients have a choice of subsequent therapies to manage their chronic pain SCS OR Biowave HOME Page 6 BiowavePENS Expanding the Continuum of Care BIOWAVE

7 Excellent Reimbursement Example Example Reimbursement Covered Payors Billing Codes Per Procedure Workers CPT $500-$700 Compensation L-Code L8680 Private Insurance and CPT $500-$800 Personal Injury Policies L-Code L8680 Medicare CPT $100-$150 L-Code Not Covered These CPT codes are being provided as examples of CPT codes that physicians have reported using in connection with seeking reimbursement for procedures related to the BiowavePENS System. It is the responsibility of each physician to independently verify and use the appropriate CPT code when seeking reimbursement for any procedures related to the BiowavePENS System. Page 7 BiowavePENS Expanding the Continuum of Care BIOWAVE

8 Great Opportunity to Grow Your Business Page 8 BiowavePENS Expanding the Continuum of Care BIOWAVE

9 Improve Care While Seamlessly Adding Significant Revenue $ Clinically Proven Blinded controlled clinical studies and over 7 years of evidenced based use in pain and spine clinics Reimbursement Private insurance and workers comp treatments typically net $300 to $650 per 30 minute treatment. Payors typically approve 6 treatments per patient, within a six week period. Large Potential Patient Pool 93% of patients with chronic back pain who have failed one or more conservative treatments. Easy to Administer Electrodes can be placed under Physician supervision. ex: Physician s Assistant, Nurse, etc. Page 9 BiowavePENS Expanding the Continuum of Care BIOWAVE

10 Clinically Proven 72 High Rate of Success Physicians report that more than 75% of patients respond to BiowavePENS treatments 1,2 Substantial Reduction in Pain Scores Patients that respond, report a 50-75% reduction in their VAS pain scores after one thirty minute treatment 1,2 Instant & Long-Lasting Pain Relief Pain relief is instant and lasts up to 72 hours 1 Reduced Opioid Use BiowavePENS treatments have been proven to lead to a 50% reduction in patient controlled Opioid use Randomized Blinded Controlled Study Treating OA Knee Patients Rush Univ. Medical Center - Published in ORTHOPEDICS June Randomized Controlled Study on the treatment of post-operative pain from TKA surgery - Hospital for Special Surgery, New York City Page 10 BiowavePENS Expanding the Continuum of Care BIOWAVE

11 Excellent Reimbursement Example Patient Economics Renee Smith, Age 56 Profit Per Patient: 6 x $ = $3, Condition: ICD 10 Codes(s): Prior Failed Treatments: Health Insurance: Chronic Lumbar Pain M54.5 Low Back Pain TENS, PT, Opioids & NSAIDS Highmark Blueshield - PA Pre-Authorized Procedure(s): CPT/HCPS Units (one unit per visit) 6 L8680 (two units per visit) 12 Reimbursement: Treatment Protocol: $ per treatment Electrodes can be placed under Physician s supervision. ex: Physician s Assistant, Nurse, etc. These CPT codes are being provided as examples of CPT codes that physicians have reported using in connection with seeking reimbursement for procedures related to the BiowavePENS System. It is the responsibility of each physician to independently verify and use the appropriate CPT code when seeking reimbursement for any procedures related to the BiowavePENS System. Page 11 BiowavePENS Expanding the Continuum of Care BIOWAVE

12 Large Untapped Patient Pool Only 1 of 6 SCS Candidates Trial the Therapy Only 1 of 2 Trial Patients (41%) Recieve an Implant 93% are Candidates for Biowave 1. St. Jude Medical Memo on file. SJM-WIT Huang, K. T., Martin, J., Marky. A., Chagoya, G., Hatef, J., Mazzard, M. A.,...Lad, S.P. (2015). A national survey of spinal cord stimulation trial-to-permanent conversion rates. Neuromodulation, 18(2), ; discussion Page 12 BiowavePENS Expanding the Continuum of Care BIOWAVE

13 Easy to Administer Easy to Use Electrodes can be placed under physician s supervision. ex: physician s assistant, nurse, medical assistant. No Programming Patient controls intensity at the touch of a button. Comfortable Treatment BiowavePENS feels like a deep smooth sensation so patient compliance is excellent. + = Page 13 BiowavePENS Expanding the Continuum of Care BIOWAVE

14 How to Get Started Page 14 BiowavePENS Expanding the Continuum of Care BIOWAVE

15 Easy as Proof of Reimbursement Let us prove to you that reimbursement works for BiowavePENS. Practice Integration Let us help you integrate BiowavePENS into your daily workflow and continuum of care. Patient Flow Let us help you grow your practice by increasing patient flow and capitalizing on missed treatment revenue. Page 15 BiowavePENS Expanding the Continuum of Care BIOWAVE

16 Proof of Reimbursement Let our reimbursement team get you paid. Biowave will handle the toughest part of the reimbursement process at no cost to you: Pre-Authorization and/or Pre-Bill Review Customized Coding Guide Denial Follow Up You focus on treating patients, we focus on reimbursement Page 16 BiowavePENS Expanding the Continuum of Care BIOWAVE

17 Practice Integration Let our integration team get you up and running. Biowave will help you integrate BiowavePENS into your practice s workflow and continuum of care. Patient selection Schedule Management Treatment Optimization You focus on treating patients, we focus on getting you up and running. Page 17 BiowavePENS Expanding the Continuum of Care BIOWAVE

18 Patient Flow Let our marketing team increase your patient flow. Biowave will help you drive incremental revenue for your practice. Point of Service Materials Marketing Programs to Existing Patients Marketing Programs to drive New Patients You focus on treating patients, we focus on driving patient flow. Page 18 BiowavePENS Expanding the Continuum of Care BIOWAVE

19 Biowave Clinical Studies 1. Randomized Controlled Study on the treatment of post-operative pain from TKA surgery - Hospital for Special Surgery, New York City. Podium Presentation at Eastern Orthopedic Association Annual Meeting, Oct 2008; Poster. Presentation at AAOS Annual Meeting Feb 2009; Study submitted to the Journal of Arthroplasty. 2. Randomized Blinded Controlled Study Treating OA Knee Patients Rush Univ. Medical Center - Published in ORTHOPEDICS June Weill Cornell Medical College Chronic Low Back Pain Study (Phase 1 + 2) Abstract from Anesthesia & Analgesia, Mar NY Giants White Paper - IRB approved study on treatment of Acute Sports Injuries on NY Giants football players June 2003-Dec 2005, 600 treatments on 160 players 5. Clinical Study on treating extremities to reduce pain and improve range of motion August 2005 Page 19 BiowavePENS Expanding the Continuum of Care BIOWAVE