On September 25, several Medicare Administrative Contractors (MACs) released draft local coverage determinations (LCDs) describing proposed coverage for Peripheral Nerve Blocks and Procedures for Chronic Pain. The MACs, including CGS Administrators, National Government Services, Noridian Healthcare Solutions, and Palmetto GBA are accepting public comments through November 8 and WPS Insurance Corporation is accepting public comments through November 22.
The draft LCDs identify several procedures used by physiatrists and other physicians treating chronic pain as being “not reasonable and necessary.” Some procedures included on the list for noncoverage PM&R physicians provide include:
- Suprascapular nerve blocks
- Thoracic nerve blocks and denervation
- Genicular nerve blocks, cryoneurolysis, or ablation
- Pudendal nerve blocks
AAPM&R will be submitting comments opposing the LCDs and in support of continued coverage for these procedures. Further, we anticipate supporting coalition comments on the LCDs, which stand to impact many members of the pain medicine community. Members who provide these services are encouraged to contact their MACs individual through written comment. Comments can be submitted by accessing the LCD for your jurisdiction here and clicking the “submit public comment” button at the top of the draft LCD or next to the public comment period date in the pop window.