Practices that perform intralaminar and transforaminal epidural injections to manage chronic pain should add 'Implement the new local coverage determination (LCD)' to their to-do list, PBN Blog has learned from Amy Turner, RN, BSN, MMHC, CPC, CHC, CHIAP, director of advisory solutions for abeo.
As of 9 a.m. ET, the following MACs had posted final versions of the LCD and related billing and coding articles. The LCDs and articles have a Dec. 5 effective date:
- CGS.
- National Government Services.
- Palmetto GBA.
- WPS.
Practices in the jurisdictions for First Coast Service Options, Novitas and Noridian should expect to see their final LCDs and articles soon.
Her main takeaway – The MACs made some clarifications and tweaks in response to comments, but they did not make radical changes to the proposed policies. Practices should start preparing now so they don't end the year with a mound of denials.
Here are four quick hits from the final policy:
- Modifier KX will be required for diagnostic blocks.
- The language on drugs and dosage levels has been clarified.
- The policies will not apply to lumbar epidurals performed as part of a pain pump trial.
- There will be more restrictions on the use of deeper levels of sedation in conjunction with epidurals