ASRA Pain Medicine, in collaboration with the International Pain and Spine Intervention Society (IPSIS) and several partner medical specialty societies, recently submitted comments to National Government Services regarding the proposed Local Coverage Determination for basivertebral nerve ablation (BVNA) as a treatment for vertebrogenic low back pain.

The organizations expressed strong support for establishing Medicare coverage for this important treatment option, which provides a non-opioid approach for patients with chronic low back pain associated with changes in the vertebral endplate. They recommended several targeted adjustments to ensure the policy aligns with current clinical evidence and real-world practices. These recommendations include clarifying psychological screening requirements, allowing flexibility in imaging criteria when an MRI is not feasible, and ensuring that imaging findings are interpreted in the context of the patient's overall clinical presentation.

The societies also suggested updates to certain exclusion criteria, including those related to osteoporosis and radicular pain, to help avoid unintended barriers to care. Overall, these updates would help ensure appropriate patient selection while maintaining access to BVNA for Medicare beneficiaries who could benefit from this therapy.

ASRA Pain Medicine will continue to collaborate with IPSIS and partner specialty societies to ensure that coverage policies reflect the best available evidence and support appropriate patient access to care.