Highmark Medicare Administrative Contractor SRS Coverage Decision Announced

Dear CKC Members,

The CyberKnife Coalition (CKC) would like to make you aware that
Highmark Medicare Services, the Medicare Administrative Contractor for
Pennsylvania, Maryland, District of Columbia, New Jersey, and Delaware
recently finalized its Stererotactic Radiosurgery (SRS) Local Coverage
Determination (LCD L32057). We are pleased to report that Highmark
agreed with our recommendations and added all of our requested
diagnoses to the list of covered indications. The following table represents
a list of the updated diagnoses and ICD-9-CM codes:

ICD-9-CM Clinical Description
170.2 Malignant neoplasm of vertebral column excluding
sacrum and coccyx
192.2 Malignant neoplasm of spinal cord
192.3 Malignant neoplasms of spinal meninges
213.2 Benign neoplasm of vertebral column excluding
sacrum and coccyx
225.3 Benign neoplasm of spinal cord
225.4 Benign neoplasm of spinal meninges
234.8 Carcinoma in situ of other specified sites
350.1 Trigeminal Neuralgia
350.8 – 350.9 Other specified Trigeminal Nerve Disorders –
Trigeminal Nerve Disorder Unspecified
747.82 Spinal vessel anomaly

Please note that the policy will be effective on 10/27/11. The LCD can be
found on Highmark’s website at the following html address:
https://www.highmarkmedicareservices.com/policy/mac-ab/l32057.html.
We are pleased that Highmark Medicare Services has made these changes
to its policy, which will allow us to offer CyberKnife treatment to more
patients suffering from painful and often life-threatening conditions.