Medicare coverage bulletin

Medicare Set-Aside Blog on February 4, 2009
Posted by


Medicare recently issued a National Coverage Determination
(NCD) regarding the issue of radiofrequency procedures for treatment of low
back pain.  This determination
specifically addresses the fact that they will no longer provide coverage for
percutaneous thermal intradiscal procedures (TIP) that are performed within the
disc itself, such as IDET.   CMS
concluded that the evidence they compiled regarding use of these procedures
does not demonstrate that TIPs improve health outcomes. When a TIP procedure is
discussed in the records you’re reviewing in preparation of a Medicare Set-Aside allocation,   it is important
to keep in mind the distinction between TIP procedures that are used to destroy
the nerves and those that are performed within the discs themselves.  Click here for more information. 




Medicare Set-Aside Allocation/Arrangement Recommendations

Submissions to Centers for Medicare and Medicaid Services

Post-Settlement Administration

Pharmacy Benefit Management