tci Part B Insider - 2014 Issue 4

Part B Coding Coach: Don't Miss Medicare's Final Decision on PILD Reimbursement

Plus: Learn about new treatment options for uncontrolled seizures. A Jan. 14, 2014, decision memo from CMS announced that “percutaneous image guided lumbar decompression (PILD) for lumbar spinal stenosis (LSS) is not reasonable and necessary under section 1862(a)(1)(A) of the Social Security Act.” The announcement did include a small silver lining, however: Medicare will cover PILD under certain conditions, outlined below. Check Your PILD Study Protocols The decision memo noted that CMS will cover PILD for Medicare patients when the treatment is provided in a clinical study “under section 1862(a)(1)(E) through Coverage with Evidence Development (CED)...

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