CMM-210: Implantable Intrathecal Drug Delivery Systems

Covered for nonmalignant chronic intractable pain, severe refractory spasticity/chronic dystonia, and cancer‑related pain (and for replacement when device is nearing end‑of‑battery life or irreparable); excluded for obstetrical/surgical epidural anesthesia, delivery of out‑of‑scope agents (e.g., Spinraza, chemotherapy, neurolytic substances, antibiotics, biologics), and investigational for other indications. Key requirements: documented prior noninvasive treatment failure (typically ≥6 months for nonmalignant pain with active rehab and fixed‑schedule systemic analgesics; ≥6 weeks of oral antispasmodics + PT for spasticity), behavioral‑health clearance and agreement to >50% opioid reduction before an opioid trial, successful percutaneous trial responses (nonmalignant permanent implant: >50% pain reduction for 8 hours plus functional gain; spasticity permanent implant: baseline Ashworth ≥3/MAS ≥2 and spasm frequency ≥2 with ≥2‑point score reduction for 4 hours after intrathecal baclofen; cancer: ≥50% pain reduction in trial or trial waived for advanced disease) and full supporting documentation.