National Coverage Analysis (NCA) Tracking Sheet

Thermal Intradiscal Procedures

CAG-00387N

Issue

Thermal intradiscal procedures, such as intradiscal electrothermal annuloplasty (IDET), percutaneous intradiscal radiofrequency thermocoagulation (PIRFT), or disc biacuplasty, are minimally invasive treatment for patients with low back pain believed to originate in the disc.  The procedures involve the insertion of a special wire or probes into the disc under imaging guidance through a small incision in the back.  Heat is applied to the disc through the use of various energy sources, such as electrical or radiofrequency.

CMS is opening this national coverage determination to complete a thorough review of the evidence to determine if thermal intradiscal procedures are reasonable and necessary for coverage under the Medicare program. 

Note:  The scope of this NCD does not include disc nucleoplasty which involves the creation of a series of channels to remove tissue from the nucleus intended to decompress the disc.

Benefit Category

Physicians' Services

Requestor Information

Requestor Name Requestor Letter
Internally generated N/A
N/A

Important Dates

Formal Request Accepted and Review Initiated
01/15/2008
Expected NCA Completion Date
10/13/2008
Public Comment Period
01/15/2008 - 02/14/2008
Proposed Decision Memo Due Date
Proposed Decision Memo Released
07/15/2008
Proposed Decision Memo Public Comment Period
07/15/2008 - 08/14/2008
Decision Memo Released
09/29/2008
Comments for this NCA
View Public Comments

Contacts

Lead Analysts
Deirdre O’Connor
Lead Medical Officers
Jyme Schafer, M.D., M.P.H.

Medicare Benefit Category Determination Date

Actions Taken

January 15, 2008

CMS initiates this national coverage analysis of thermal intradiscal procedures. The initial 30-day public comment period begins with this posting date, and ends after 30 calendar days.

CMS is requesting public comment on the health benefit outcomes of thermal intradiscal procedures in the Medicare population.

CMS considers all public comments, and is particularly interested in comments regarding clinical studies and other scientific information about the technology under review and the short and long term outcomes.

Instructions on submitting public comments can be found at http://www.cms.hhs.gov/Medicare/Coverage/InfoExchange/publiccomments.html. You can also submit a public comment by clicking on the highlighted word comment in the title bar at the top of this page. We strongly urge that all public comments be submitted through this website. Please do not submit personal health information in public comments. Comments with personal health information may not be posted to the website.

March 11, 2008

Posted comments [PDF, 1MB] received.

View comments received through the website.

July 15, 2008

CMS posts the proposed decision memorandum and invites public comment.

CMS is requesting public comment on this proposed decision memorandum. CMS considers all public comments and we are particularly interested in comments that include evidence we did not review or comments that assess how we evaluated the evidence included.

In general, CMS does not need individually identifiable health information to inform its proposed or final decisions. Any public comment received with individually identifiable health information will not be posted to the CMS website at this time. Examples of individual personal health information can be found at the bottom of the comment submission form.

Instructions on submitting public comments can be found at http://www.cms.hhs.gov/Medicare/Coverage/InfoExchange/publiccomments.html. You can also submit a public comment by clicking on the highlighted word comment in the title bar at the top of this page. We strongly urge that all public comments be submitted through this website.

September 29, 2008