Another Medicare Administrative Contractor to cover MIS SI joint fusions — 5 key updates

Spine

Cahaba Government Benefit Administrators, a Medicare Administrative Contractor, will now cover minimally invasive sacroiliac joint fusion procedures.

Here are five things to know:

 

1. Cahaba Government Benefit Administrators covers Medicare beneficiaries in Alabama, Georgia and Tennessee.

 

2. The coverage is for percutaneous sacroiliac minimally invasive joint stabilization arthrodesis, CPT 27279.

 

3. Coverage will begin June 1. The procedure will not be considered experimental at that point.

 

4. Cahaba covers more than 3 million Medicare beneficiaries.

 

5. All together, there are four MACs with a positive coverage decision for minimally invasive SI joint fusion, bringing the total beneficiaries able to access the procedure to 27 million.

 

"Cahaba's decision reinforces the fact that MIS SI joint fusion, for appropriately-selected patients, is safe and effective and not investigational," said SI-BONE Vice President, Health Outcomes & Reimbursement Michael Mydra.

 

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