Radiology societies express ‘significant concern’ around proposed BlueCross BlueShield policy

Radiology societies are expressing “significant concern” around a payment policy from BlueCross BlueShield.

BCBS of Tennessee last month proposed curtailing coverage for peripheral nerve stimulation devices, used to relieve pain. The American Society of Neuroradiology and American Society of Spine Radiology, among others, recently wrote to the 3.3-million-member health plan, urging BCBS to reconsider the draft decision.

The radiology societies also highlighted the advocacy effort in a July 7 news update. Others signing the letter included the American Society of Anesthesiologists and the Spine Intervention Society, altogether representing thousands of physicians.

“This draft language has created significant concern among the pain medicine community given the increasingly important role that PNS plays in the management of persistent and chronic pain,” the societies wrote to BCBS of Tennessee.

Radiologists contend that the policy would put patients at increased risk of escalated opioid use or undergoing more invasive surgical options. They note that PNS has been proven effective at treating concerns such as phantom limb, neuropathic or axial low-back pain. The societies cited a 2021 literature review, which concluded that peripheral nerve stimulation offers “moderate to strong evidence for effective treatment of pain and improvement of quality of life.”

“Considering the above, we urge BCBSTN to decline implementing this draft policy and allow coverage of the peripheral nerve stimulation system when medically necessary in the treatment of patients suffering from moderate to severe subacute and chronic pain who have failed conservative treatment,” they closed.

The newly proposed policy, linked to in the letter as of June 14, appeared to have been taken down as of Tuesday.

Marty Stempniak

Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic. 

Around the web

The nuclear imaging isotope shortage of molybdenum-99 may be over now that the sidelined reactor is restarting. ASNC's president says PET and new SPECT technologies helped cardiac imaging labs better weather the storm.

CMS has more than doubled the CCTA payment rate from $175 to $357.13. The move, expected to have a significant impact on the utilization of cardiac CT, received immediate praise from imaging specialists.

The all-in-one Omni Legend PET/CT scanner is now being manufactured in a new production facility in Waukesha, Wisconsin.

Trimed Popup
Trimed Popup