CMM-210: Implantable Intrathecal Drug Delivery Systems

Covers implantable intrathecal/epidural drug delivery systems for non‑malignant chronic intractable pain, severe refractory spasticity/chronic dystonia, cancer‑related pain (trial waived only for advanced disease/limited survival/high procedural risk), and medically necessary pump replacement; excludes obstetrical/surgical epidural anesthesia and intrathecal/epidural use for Spinraza, chemotherapy, neurolytic agents, biologics, or other non‑covered injectates. Key requirements: documented conservative therapy (for non‑malignant pain ≥6 months of provider‑directed non‑invasive care including active rehab and scheduled analgesics unless contraindicated), behavioral‑health clearance, >50% reduction in systemic opioids before an intrathecal opioid trial, percutaneous trial with prespecified response thresholds (≥50% pain reduction for 8 hours plus improved function for permanent non‑malignant implants; spasticity requires baseline Ashworth/MAS and ≥2‑point reduction for 4 hours post‑baclofen bolus), and documentation of device end‑of‑life/failure for replacements.