Lee Chesterfield Nov 6, 2017 06:41 AM
One has to wonder why there are only 2 states that are no longer allowing spinal cord stims in WC. Review the data used to make the guideline and make sure that data actually states it was not recommended. MTUS is being used to unilaterally deny certain treatment requests. Often times a patients condition(s) are complex and do not fall under a basic guideline. Make sure in your appeals you are stating this and find better evidence that shows the request is warranted. With appeals I mean internal UR appeals and not IMR. You will have a much better chance doing internal UR appeal and leave IMR for last resort. Researching maud events on the FDA website it is clear there are certain stimulators that are causing a lot of problems. I hope physicians who are requesting spinal cord stimulators will take some time to review this data on the device their sales rep is recommending.