SUBJECT: Support for Coverage for Magnetic Resonance Image-Guided High Intensity
Focused Ultrasound (MRgFUS) for Essential Tremor (ET) LCD L33777
Dear Drs. Schaening and Campbell:
On behalf of the American Association of Neurological Surgeons (AANS), the Congress of Neurological
Surgeons (CNS) and the American Society for Stereotactic and Functional Neurosurgery (ASSFN), we
appreciate the opportunity to express our support for the recent formal reconsideration request for the
First Coast Local Coverage Decision (LCD) L33777 for Magnetic Resonance Image Guided High
Intensity Focused Ultrasound (MRgFUS) for Essential Tremor (ET). We urge First Coast to reconsider
its policy regarding this procedure and begin the process of issuing a positive coverage policy for
MRgFUS for the treatment of essential tremor (ET) for patients with medication-refractory tremor.
Representatives of the AANS, the CNS and the ASSFN have actively supported coverage for MRgFUS
for ET, reported with CPT Category III Code 0398T. Recently, leaders of the ASSFN performed a
comprehensive review of published literature on MRgFUS for ET and developed the attached position
paper. We hope this thorough examination of the medical evidence will be useful in your decision making process.
First Coast continues to be an outlier among other Medicare payers regarding coverage of this important
procedure. Currently, five Medicare Administrative Contractor (MACs) provide coverage for MRgFUS.
For patients with essential tremor that is refractory to medical treatment, MRgFUS is an alternative to
open surgical treatment methods that involve incising the skin, opening the skull and passing surgical
instruments through brain tissue. Neurosurgery has actively participated with several MACs to support
coverage for MRgFUS for appropriately selected patients and provided guidance regarding details of
their policies.
Read full letter here
