CMS Opens National Coverage Analysis For Percutaneous Image-Guided Lumbar Decompression
This article was originally published in The Gray Sheet
The Medicare agency is requesting public comment on the clinical evidence of short-term and long-term health benefit outcomes of this procedure to diagnose and treat lumbar spinal stenosis.
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Medicare will only cover percutaneous image-guided lumbar decompression as part of qualifying clinical trials under a final national coverage determination. OIG scrutinizes Medicare Administrative Contractor performance and local coverage determination inconsistencies. More reimbursement briefs.
Two medical device makers that stand to lose under CMS’ proposed noncoverage of percutaneous image-guided lumbar decompression say the agency’s proposal would unwisely eliminate a promising alternative to invasive surgery for the treatment of lumbar spinal stenosis. One suggests coverage with evidence development to allow more data collection, an approach also advocated by the North American Spine Society.
The procedure, aimed at treating lumbar spinal stenosis, is not reasonable and necessary, the Medicare agency says. A final decision is due Jan. 15.