May 14, 2026

ACR® and the Society of Interventional Radiology submitted comments to five of seven Medicare Administrative Contractors about a proposed local coverage determination (LCD) for botulinum toxin injections.

ACR and SIR raised concerns about the omission of image-guided preoperative botulinum toxin use in complex ventral hernia repair. The societies said this approach plays an important role in modern abdominal wall reconstruction and should be recognized as a covered service. They said coverage would support safe, effective care and better patient outcomes.

ACR’s Contractor Advisory Committee Network monitors all LCDs relevant to radiology, and in most instances, each clinical topic is reviewed annually for potential updates to coding or coverage criteria.

The College will continue to collaborate with partner societies and MACs to promote evidence-based policies that ensure safe, effective care for Medicare beneficiaries.

For more information or if you have questions, contact Alicia Blakey, ACR Manager of Economic Policy.

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