Dear WIPM Members, 

Alert!!

Noridian Healthcare Solutions has proposed a draft Local Coverage Determination (LCD) for Peripheral Nerve Blocks and Procedures for Chronic Pain. https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=0&lcdid=40264&ver=7

This LCD would impose significant coverage limitations to trigeminal nerve, median nerve & Mortons neuroma injections.

More impactful, it would eliminate the following interventional treatments from coverage: Trigeminal nerve, Morton's neuroma, median nerve injections are subject to multiple limitations.

It is not reasonable and necessary for therapeutic PNBs, peripheral nerve denervation from ablation (RFA)* or cryoneurolysis for the treatment of:

*Peripheral nerve ablation includes thermal RFA, cooled RFA, pulsed RFA, water-cooled RFA and other percutaneous strategies such as balloon compression, glycerol rhizotomy, and microvascular decompression.

  1. Occipital nerve block and denervation

  2. Stellate ganglion block

  3. Trigeminal nerve block

  4. Suprascapular nerve block

  5. Thoracic nerve block

  6. Thoracic nerve denervation

  7. Genicular nerve blocks (GNB), cryoneurolysis or ablation

  8. Pudendal nerve block

  9. Digital nerve block

  10. Posterior tibial nerve block at the tarsal tunnel

  11. Ulnar nerve block

  12. Denervation of the trigeminal nerve for any diagnosis other than TN

  13. Any other peripheral nerves blocks, or denervation not listed above

Remarkably, the proposed policy specifically targets the use of these procedures for the treatment of Chronic Pain. It provides exceptions include blocks for regional anesthesia, acute surgical and palliation of malignant purposes.

The WIPM Board of Directors has prepared a response, please see below.

For such a threatening policy proposal, we also implore all members to take action!!

  1. Raise awareness by forwarding this message to your colleagues in Pain Medicine and other associated subspecialities.

  2. Send letters before November 7th to: policydraft@noridian.com. Click below to download a pre-drafted letter you can sign and submit to the email address listed above.

  3. Register for the Open Public Meeting - Thu, Oct 30, 2025 3:00 PM - 5:00 PM EDT

Pre-Drafted Letter
Register
WIPM's Response

Welcome to The Society of Women Innovators
in Pain Management

 

We encourage and empower current and future women pain leaders to realize their professional and personal goals. We do this through a commitment to mentoring, supporting, educating, training and developing future influencers within our field.

WIPM was founded in 2019 by a small group of female physicians who recognized the under representation of women in the field of pain management. The goal of this organization is to be a stand alone
entity who can act as the collective voice for women in pain management.

 

Ready to take the next step? Become a member of our society!

JOIN TODAY

WIPM Position Statement - Implantable Peripheral Nerve Stimulation (PNS)

View Position STatement