Nevro Corp. today announced that Noridian, the Medicare Administrative Contractor (MAC) that oversees the majority of the western United States, released an update to their Local Coverage Billing and Coding article (A57791 and A57792) for spinal cord stimulators for chronic pain to include two new ICD-10 codes that cover Painful Diabetic Neuropathy (PDN). This change was posted on March 4, 2022 and is retroactive for procedures performed on or after January 1, 2022.
“This is a very positive advancement for the Medicare-aged population covered by Noridian, which will provide greater access to Nevro’s proprietary 10 kHz Therapy for PDN patients,” stated D. Keith Grossman, Chairman, CEO and President of Nevro. “The coverage policies of five of the seven regional Medicare MACs now provide access for PDN patients. Our reimbursement team is continuing to work closely with the remaining Medicare MACs as well as commercial payers to provide the published clinical literature for 10 kHz Therapy and to respond to any questions raised during their policy reviews. We believe our strong and growing body of published, peer-reviewed clinical and real-world data will be the basis for further coverage decisions by other major health plans in 2022 and beyond.”
This Medicare update from Noridian, coupled with the recent positive coverage decision from UnitedHealthcare, increases coverage in the US to approximately 43% of PDN patients, up from approximately 25% of patients at the end of 2021. Noridian covers Medicare patients in Alaska, Arizona, California, Hawaii, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington and Wyoming.
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