Earlier this year, Noridian posted a draft Local Coverage Determination that would have eliminated any and all coverage for lumbar paravertebral facet joint injections, facet joint nerve blocks and denervation procedures, which would affect patients and physicians in the western and northern plains states, according to the release. The 12 societies have proposed an alternative to NAS that, if accepted, will preserve coverage of these important services for patients located in the LCD.
Facet injections have been under governmental scrutiny since Sept. 2008 when the Office of Inspector General issued a report that cited serious issues involving miscoding and mispayment, according to the release. The proposal from the societies includes some limits on the number and frequency of the procedures that may be performed, but all the specialties agree that this is consistent with expert opinion and evidence currently available in the medical literature and is far better than no coverage at all.
The Carrier Medical Directors will review the proposal and determine the final LCD at some point in the future.
Read the release about maintaining coverage for facet joint injections.
