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Implantable and External Infusion Pumps for Pain or Spasticity - Medicare Advantage (Revised)

Humana·Pain Management, Neurology, Neurosurgery +2 more·Pharmacy
Effective date
Jul 1, 2026
We identified it
Jun 30, 2026
Days to comply

Summary

This revised Medicare Advantage policy (effective 07/01/2026) establishes specific clinical criteria for implantable and external infusion pumps for pain and spasticity management. Key changes include: requiring a baseline Modified Ashworth Scale score of ≥3 for baclofen trials, mandating a 2-point MAS reduction for permanent implantation, and defining 'failure of conservative therapy' requirements with a 50% pain reduction threshold for opioid/non-opioid trials. The policy also clarifies replacement/revision criteria and addresses postoperative external pumps.

Action Required

Action needed
By 06/01/2026: Billing and clinical teams must update prior authorization protocols and medical necessity documentation requirements. (1) Modify PA templates to require: baseline MAS score ≥3 for intrathecal baclofen trials (CPT 62322-62327, C2626); documented failure of conservative therapy for pain management trials; and 50% pain reduction confirmation for permanent pain pump implantations. (2) Update provider encounter forms and clinical notes to capture Modified Ashworth Scale scores pre- and post-trial. (3) Train coding staff on geographic MAC jurisdictions (DME MACs A-D and Part A/B MACs JE, JF, JJ, JM) and ensure correct LCD application per state. (4) Review existing pending claims for spasticity/pain pump procedures and re-submit with updated MAS documentation if previously lacking. (5) Coordinate with providers to ensure trial data collection and documentation of clinical outcomes before requesting permanent implant authorization. Non-compliance will result in claim denials for insufficient documentation of severity metrics and trial success thresholds.

Affected Billing Codes

62322
62323
62324
62325
62326
62327
62350
62351
62355
62360
62361
62362
62365
C1772
C1891
C2626
E0782
E0783
E0785
E0786