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 CMS coverage and analysis group has had to divert its attention from finishing a CED guidance to finalizing proposed changes to the process for awarding Medicare coverage for investigational device trials, primarily due to staff cuts, says Louis Jacques, who heads the group.