Multiple Local Coverage Determinations (LCDs) Open Public Meeting - February 15, 2024 - JE Part A

Jocelyn Fernandez:
Good afternoon, or maybe good morning, depending on where you're calling from.

My name is Jocelyn Fernandez, and I am one of the Medical Policy Specialists here at Noridian Healthcare Solutions. Before we begin the meeting, I would like to make the following announcements. This meeting will be recorded. The recording and written transcript will be posted on our website following today's meeting.

All lines are currently being muted and will remain muted throughout the meeting.

I will now turn this meeting over to Dr. Eileen Moynihan.

Dr. Moynihan, you may begin.

Dr. Eileen Moynihan:
Welcome everyone. And thank you so much for the time you’re sparing to attend our meeting.

Our first topic is Cervical Fusion.

And we actually have no one who has registered to speak for this meeting.

This policy was a multi-MAC collaboration, and it was formulated to provide an evidenced based policy for Cervical Fusion, which will help assist us in the Prior Authorization project that we have already with CMS.

I think there will be details later about how to make comments on this, but since we have no presentations, I think we can conclude this topic.

The next LCD was also a collaborative LCD, it is Facet Joint Interventions for Pain Management.

This particular LCD is currently active, but open for comment in two distinct areas.

This revision will provide clarifying language and supporting evidence on the use of anesthesia in conjunction with facet injections and radio frequency ablation.

The number of levels covered under the policy is clarified and reviewed in rationale for decision making.

Response to a reconsideration requesting expansion of therapeutic joint injection as a first line option has been added to the summary of evidence section, with the rationale for the decision explained.

No coverage changes were made because of that reconsideration request.

I would point you to the limitation section, numbers 2 and 3, with regard to more firm statements on anesthesia and to limitation number seven dealing with the number of facets that are treated at a time.

I'd also want you to be aware that CPT defines a level as the number of facet joints injected, not the number of nerves. If multiple nerves are injected for the same facet joint, this is a single facet. Some confusion does exist over counting of those, but you will find that definition in CPT.

So, this is a little bit more unusual. The entire document is not open for comment.

Only the sections dealing with anesthesia and dealing with the number of facet joint limitation are open for comment.

So we have no public speakers that have registered to speak, and I think we can close on this document.

Jocelyn Fernandez:
In closing, we would like to communicate the next steps in the policy development process.

The comment period for the proposed LCDs will remain open until March 2, 2024.

All comments to be considered by our Medical Directors for the proposed LCDs must be submitted in writing.

Written comments can be emailed to policydraft@noridian.com, or mailed to the address on your screen.

Comment information for our proposed LCDs are located on our website at noridianmedicare.com

Upon review of the comments our Medical Directors will either finalize or retire the proposed LCDs. Responses to comments will be viewable in the Response to Comments article.

Please monitor our website or register for ListServ notifications to be informed of actions taken on our proposed LCDs. Dr. Moynihan, do you have anything else you would like to say before we end this meeting?

Dr. Eileen Moynihan:
Only to thank everyone, again, for their attention and participation.

Jocelyn Fernandez:
All right. So this concludes our meeting, thank you for attending the Noridian Open Public Meeting.