CMM-210: Implantable Intrathecal Drug Delivery Systems

Covers implantable intrathecal/epidural drug delivery systems only for nonmalignant chronic intractable pain, severe refractory spasticity/chronic dystonia (intrathecal baclofen), and cancer‑related pain; all other indications—including intrathecal chemotherapy or antibiotics—are experimental/investigational and excluded. Key requirements: objective documented pathology and a successful percutaneous trial plus documentation of prior therapy failure (≥6 months noninvasive treatment for nonmalignant pain with agreement to >50% systemic opioid reduction and ≥50% pain reduction for ≥8 hours during trial; for spasticity either failure/intolerance of ≥6 weeks oral therapy/physical therapy OR baseline Ashworth/Modified Ashworth and Spasm Frequency thresholds with ≥2‑point trial improvement; cancer pain requires failure/intolerance of noninvasive methods or documented limited survival if trial omitted), and pump replacement is allowed only for documented end‑of‑life/nonrepairable devices with no evidence of abuse.