IPSIS Calls for Facet Joint Intervention LCD Corrections

On February 6, 2025, IPSIS submitted letters to six Medicare Administrative Contractors (MACs) proposing crucial corrections to the language in Local Coverage Determinations (LCDs) for Facet Joint Interventions in Pain Management, specifically addressing facet joint denervation criteria.

A major issue within the Noridian and First Coast Service Options LCDs is the erroneous use of "AND" in the repeat RFA criteria, imposing unnecessary restrictions on patient access to care. Other MACs have maintained clearer language consistent with the original intent, ensuring necessary treatments remain available. A formatting issue across all MAC LCDs has also led to the incorrect grouping of repeat RFA criteria with initial RFA requirements, creating confusion and limiting eligibility for long-term patients.

Click the contractor name to download the letters 🔒:

CGS
FCSO
NGS
Noridian
Novitas
Palmetto
WPS

You can also help sustain this vital advocacy with your donations. The International Pain and Spine Intervention Society (IPSIS) is a tax exempt organization under US section 501(c)(3) of the Internal Revenue Code. As such, contributions are deductible to the extent allowed by law.