A recently proposed Medicare Administrative Contractors policy aims to restrict coverage for peripheral nerve blocks and related procedures used to treat chronic pain, but anesthesiologists and pain medicine physicians are concerned about potential consequences of the policy.
Under the proposed policies, coverage would be limited to radiofrequency neurolysis for trigeminal neuralgia, up to three corticosteroid injections for median neuropathy at the wrist and up to two corticosteroid injections for Morton’s neuroma, ASRA Pain Medicine reported Oct. 16. All other peripheral nerve block and denervation procedures would be deemed noncovered services.
In a Nov. 12 news release shared with Becker’s, the American Society of Anesthesiologists denounced the proposal and urged MACs to reverse it.
“For decades, chronic pain patients have received treatment from PNBs and ablation techniques that provide rapid and durable pain relief, enhance function and quality of life, and decrease reliance on systemic pain medications, including opioids,” said ASA President Patrick Giam,MD. “We urge Medicare to consider the compelling clinical and functional evidence that supports coverage of PNBs and related procedures.”
In a formal communication to MACs, the ASA cited numerous studies, medical society guidelines, expert consensus and real-world evidence to underscore the effectiveness and importance of PNBs in treating chronic pain. Additionally, it emphasized in its comments the importance of Medicare coverage for these treatments in decreasing patients’ reliance on opioids.
“This can prevent opioid misuse in the nearly four million Americans who initiate long-term opioid use every year after a routine surgical procedure,” the ASA said in the release. “ASA is actively collaborating with other pain and medical societies to address the broad implications of these type of care denials and will continue to advocate for patient access to effective and necessary treatment options.”
