April 28, 2011
All Blue Cross Contracting ProvidersFrom:
Connie Winkley – Education/Communication Coordinator
Blue Cross and Blue Shield of Kansas, Inc.
An Independent Licensee of the Blue Cross and Blue Shield Association
Image-Guided Minimally Invasive Lumbar Decompression (IG-MLD) for Spinal Stenosis
Blue Cross and Blue Shield of Kansas has developed a policy based on the Blue Cross and Blue Shield Association (BCBSA) policy for Image-Guided Minimally Invasive Lumbar Decompression (IG-MLD) for Spinal Stenosis. BCBSA considers this procedure to be Experimental / Investigational (E/I).
CMS created C9729 code for the above procedure which is effective April 1, 2011 through June 30, 2011.
Effective July 1, 2011, there will be a CPT category III code (0275T) that is applicable to the above listed procedure.
It is recommended to have the patient complete a Limited Patient Waiver (LPW) form. These charges will be denied as a provider write-off unless the provider obtains an LPW signed by the patient. By obtaining a signed LPW, the E/I charges will be denied as the patient’s responsibility. This form is available by clicking on the link below.http://www.bcbsks.com/CustomerService/Forms/pdf/15-169_limited_pat_waiver.pdf