WEST CHESTER, PA — Tennessee’s largest commercial payer, representing 2.3 million insured individuals, has expanded coverage for one- and two-level lumbar total disc replacement (TDR) procedures. This includes coverage for Centinel Spine’s prodisc L, the only lumbar TDR system approved in the U.S. for both one- and two-level use in the lumbar spine.
This policy expansion, effective March 1, 2024, is a major stride towards comprehensive coverage for these procedures across the U.S. With this update, it is estimated that almost 94% of commercially-insured individuals in the country now have access to one-level lumbar TDR procedures. Coverage for two-level procedures, while less widespread, is steadily increasing, with over 30% of insured individuals now covered.
Centinel Spine, the Chester County, Pennsylvania-based medical device company focused on addressing cervical and lumbar spinal disease, hailed the move as a significant step forward in patient care. “The top commercial payer in Tennessee has now provided much-needed one- and two-level lumbar total disc replacement access to a significant number of individuals,” said Steve Murray, CEO of Centinel Spine. “We have seen an acceleration of positive lumbar disc replacement coverage over the last six months. This is good for patients, and we believe this trend will continue as other payers recognize the clear and published clinical benefits of the total disc replacement procedure.”
Total disc replacement is a type of spine surgery that involves replacing a painful disc with an artificial one. It’s often used to treat chronic pain conditions in the spine that haven’t responded to non-surgical treatments. The procedure can be performed at one level, meaning one disc is replaced, or at two levels, where two adjacent discs are replaced.
Centinel Spine’s prodisc L is a lumbar disc replacement device that has been shown to maintain or improve motion at the implanted level. Its approval for two-level use means it can be used to replace two adjacent discs in the lumbar spine, offering a viable alternative to spinal fusion surgery for certain patients.
The coverage expansion in Tennessee follows similar moves in other states. In 2023, large payers in Illinois, New Mexico, Oklahoma, and Texas, representing over 16 million insured individuals, adopted criteria deeming one- and two-level lumbar TDR medically necessary. Similar measures were also adopted by the largest commercial payer in Michigan, adding another 5.7 million insured individuals to the list of those with access to these procedures.
These developments highlight the growing acceptance of lumbar TDR as a viable treatment option for certain spinal conditions. As more insurers recognize the benefits of these procedures and extend coverage, more patients will have access to this potentially life-changing treatment.
Centinel Spine, LLC stands out as a premier global medical device company dedicated to tackling cervical and lumbar spinal conditions. Their prodisc technology, renowned as the most extensively researched and proven total disc replacement system worldwide, boasts validation through over 540 published papers and more than 250,000 successful implantations. Notably, the prodisc differentiates itself as the sole TDR technology providing diverse motion-preserving anatomical solutions. This versatility empowers surgeons to tailor the disc to each patient’s unique anatomy, for both cervical and lumbar total disc replacements.
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