Medicare Palmetto Removes MIS SI Joint Fusion From Non-Coverage

The Medicare Administrative Contractor Palmetto GBA announced it will cover minimally invasive sacroiliac joint fusion procedures on a case-by-case basis, according to a news release from SI-BONE.

Palmetto removed CPT code 0334T that was used to report the MIS SI joint fusion using SI-BONE's iFuse procedure from their list of non-covered services. It is the first Part A/B MAC in the United States to take this action.

Medicare beneficiaries in North Carolina, South Carolina, Virginia and West Virginia will receive coverage for MIS SI joint fusion. The decision was based in part on published clinical data demonstrating the safety, effectiveness and clinical value of the procedure. iFuse received FDA clearance in 2008.

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