The American College of Radiology® Contractor Advisory Committee (CAC) Network has tracked the development of an updated local coverage determination (LCD) on this topic since May 2020. As of today, all seven Medicare Administrative Contractors (MACs) have released the final LCD, billing & coverage article and the response to comments article on this topic. The policy becomes active on April 25, 2021 for most MACs, and the rest by May 1, 2021. This topic is significant for interventional radiologists and pain management communities.
This policy was developed and adopted by all the MACs and therefore represents equivalent coverage across the states. The lead Contractor Medical Director (CMD) has requested that societies educate members on the new policy and associated billing and coding article. Register for An Evening Discussion on Facet Joint Intervention for Pain Management (L38773). The event is scheduled for April 14, 2021 and hosted by CGS Administrators, LLC.
We encourage you all to review this policy in-depth to avoid future claim denials. At this time, comments are not being solicited. If key changes are needed to the policy, a reconsideration request can be submitted once the policy is active. The requirements for reconsideration are posted on each MAC's website.