Radiology societies ‘extremely disheartened’ over elimination of Medicare coverage for key procedure
The American College of Radiology, alongside several pain-management groups, said it is “extremely disappointed” over a recent decision to eliminate Medicare coverage for a key interventional procedure.
ACR and others shared their concerns in a March 7 letter. They note that five of the seven Medicare Administrative Contractors have opted to discontinue payment for sacroiliac joint radiofrequency ablation—a procedure that uses radio waves to destroy nerves and relieve pain.
Provider groups are urging MACs to reconsider the decision and maintain access to this treatment. Others signing the letter included the American Society of Neuroradiology, American Society of Spine Radiology and the Society of Interventional Radiology.
“We are extremely disheartened to learn that the Medicare Administrative Contractors have eliminated access to sacroiliac joint radiofrequency ablation for Medicare beneficiaries—a procedure proven to be safe and effective in providing pain relief and functional improvement in appropriately selected patients,” ACR et al. wrote to Meredith Loveless, MD, chief medical officer of A/B MAC Jurisdiction 15. “Patients being considered for this procedure are those who have already failed conservative treatment. Prohibiting access to sacral lateral branch radiofrequency neurotomy will leave them with only surgery or opioids as their alternative covered treatment options.”
The CMS pain management workgroup first released news of the local coverage determination in February, with it taking effect for services provided on or after March 19. MACs are contending that there is a lack of established practice standards and long-term outcomes data, the college noted in a Friday news update.
But radiologists and pain-management specialists believe that is untrue and are asking for a chance to work with MACs to revise the coverage criteria.
“The undersigned societies believe the current literature supports these procedures, but also look forward to providing additional comments and robust literature to support sacroiliac joint interventional access in the future,” the groups wrote.
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.