SUBJECT: LCD DL34555-Draft LCD for Non-Covered Category III CPT Code 0398T:
MRgFUS stereotactic lesion ablation
Dear Dr. Garrett,
The American Association of Neurological Surgeons (AANS), Congress of Neurological Surgeons (CNS)
and the American Association of Stereotactic and Functional Neurosurgery (ASSFN) appreciate the
opportunity to comment on the proposed local coverage determination (LCD) titled “Non-Covered
Category III CPT Codes: DL34555,” specifically as related to CPT code 0398T (MRgFUS stereotactic
lesion ablation for the treatment of movement disorders). Based on the current literature, we request that
Palmetto cover unilateral MRgFUS thalamotomy for patients with essential tremor who cannot be
controlled with medication therapy.
Approved procedures for treatment of essential tremor currently include:
- CPT 61720 Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; globus pallidus or thalamus;
- CPT 61863 Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (e.g., thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use of intraoperative microelectrode recording; first array;
- CPT 61867 Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (e.g., thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording; first array; and the associated “additional array” codes (CPT +61864, CPT +61868).
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