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Medicare Slightly Expands Coverage For Spine Procedure, But Policy Remains Trial-Limited

 
• By Reed Miller

Vertos Medical asked the US Medicare agency to reconsider its 2014 decision that limits coverage of percutaneous image-guided lumbar decompression for lumbar spine stenosis to certain clinical trials. The agency ruled Dec. 7 that it will stick with the trial-limited policy, but expanded it to include longitudinal studies.

The US Centers for Medicare and Medicaid Services is maintaining its coverage-with-evidence-development (CED) approach to percutaneous image-guided lumbar decompression (PILD) for lumbar spinal stenosis, but will expand the coverage policy to include longitudinal studies. CMS issued its National Coverage Analysis decision memo for the PILD procedure Dec. 7.

In 2014, CMS agreed to cover PILD for patients enrolled in an approved clinical trials that meet certain criteria. (Also see "Spine Firms Laud CMS’ Decision To Cover Percutaneous...

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