Noridian Adopts IPSIS-Suggested Coverage Changes

Following IPSIS advocacy, Noridian has made critical coverage updates which align Noridian’s policies with national standards and reduce unnecessary documentation burdens for interventional pain physicians.

Epidural Steroid Injections
Noridian has revised its billing and coding article for Epidural Steroid Injections (ESIs) to remove the requirement for documenting percent pain relief following therapeutic transforaminal epidural steroid injections (TESIs).

By adopting the specific IPSIS-suggested-wording for this change, Noridian’s policy is now aligned with those of all other Medicare Administrative Contractors (MACs) — eliminating a trigger for improper audits or denials due to outdated or inaccurate documentation expectations. View the updated policy here.

Facet Joint Interventions
After IPSIS called attention to confusing formatting and contradictory logic in the criteria for repeat radiofrequency ablation (RFA), Noridian has now clarified their Facet Joint Interventions LCD agreeing to IPSIS suggestions to distinguish between initial and repeat RFA procedures and revise the policy language to:

• Avoid requiring both two medial branch blocks (MBBs) and a prior successful RFA to qualify for a repeat RFA,
• Ensure repeat RFAs are not held to inconsistent or unintentional documentation standards, and
• Align with clinical intent and policy language used by other MACs.

Noridian has now updated the LCD to reflect these recommendations. The revised policy is available here.

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