The American College of Radiology® (ACR®) and other medical specialty societies that use or perform interventional pain and spine procedures submitted a letter to five of the seven Medicare administrative contractors (MACs) their final local coverage determination (LCD) on Trigger Point Injections (TPI). Celerian Group Company Administrators, LLC, Noridian Healthcare Solutions, LLC, National Government Services, Inc., Palmetto GBA and Wisconsin Physicians Service Insurance Corporation deem ultrasound guidance for TPIs as investigational because of a lack of evidence of enhanced safety.
The specialty societies encourage these MACs to review new guidelines that support the use of ultrasound guidance for TPIs in specific anatomic locations. Without ultrasound guidance availability, diagnostic relevance is lost and the safety of certain TPI injections (e.g., anterior neck muscles, deep gluteal muscles, chest wall) are greatly reduced.
The ACR Contractor Advisory Committee (CAC) Network representatives relayed their concerns about this adverse LCD in March.
For more information or if you have questions, contact Alicia Blakey, ACR Principal Economic Policy Analyst.