Focusing back on the matter at hand (instead of focusing on these first time downrampers), if we were to look at the latest 4 MAC LCDs (and please correct me if I'm reading these wrong, and no I haven't read all the details...), specifically their coverage limitation section reads almost exactly alike (same as the WPS one) and have all specifically named OMNI. So if Sight Sciences can't convince these MACs to hold off on implementation (i.e. end of December), they're effectively toast until they seek reconsideration of their 36mth study (still awaiting peer review). You have to wonder whether one study is sufficient to convince the MACs to go through the whole process again.
The flipside is Nova's sales force need to rapidly inform/teach all their 200+ surgeons to to switch from ab-interno to ab-externo within the month? =P
"Limitations of Coverage
- The following are considered investigational in patients over the age of 18 for glaucoma management:
- Excimer laser trabeculostomy (i.e., ExTra ELT)
- Viscocanaloplasty
- Canaloplasty in combination with trabeculectomy ab interno (e.g.,OMNI® Surgical System)
- Gonioscopy-assisted transluminal trabeculectomy (GATT)
- Ab Interno Canaloplasty
- Transcliary Fistulization
"
- MIGs is not considered a first line treatment for mild-moderate glaucoma.
- A combination of surgical MIGs procedure and aqueous shunts cannot be performed at the same time of service in the same patient.
- Phacoemulsification can be performed in conjunction with a single MIGS procedure (stent or surgical but not both at same time of service
List of MACs
https://www.cms.gov/files/document/macs-state03282023pdf.pdf
https://www.cms.gov/files/document/ab-jurisdiction-map03282023pdf.pdf
L37578 - CGS Administrators
L37244 - National Govt. Services
L38299 - Noridian Healthcare Solutions
L38301 - Noridian Healthcare Solutions
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