Severe Emphysema Surgery Program Comes to Pittsburgh

UPMC eligible for Medicare reimbursement

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Rodney Landreneau, MD, co-director of the Severe Emphysema Surgery Program at UPMC (UPMC)

The University of Pittsburgh Medical Center (UPMC), through the newly created Severe Emphysema Surgery Program, has become the only institution in the Pittsburgh region to be certified by the Centers for Medicare & Medicaid Services (CMS) to receive Medicare reimbursement for lung volume reduction surgery (LVRS) as a treatment for emphysema. UPMC is one of only 44 centers nationwide to be eligible for Medicare reimbursement for this procedure.

LVRS, also known as reduction pneumoplasty, lung shaving or lung contouring, is an invasive surgical procedure to reduce the volume of a hyperinflated lung in order to allow the underlying compressed lung to expand and establish improved respiratory function.

Emphysema is the destruction and enlargement of the lungs' peripheral air sacs and affects an estimated 2 million people in the United States. Smoking causes the majority of cases. Because of emphysema, the lungs are over-expanded at all times and the movement of air from the chest cavity is greatly reduced.

"Short of lung transplantation, this surgery has the potential to provide a significant benefit to help patients with severe emphysema," says Rodney Landreneau, MD, co-director of the program, professor of surgery at the University of Pittsburgh School of Medicine and director of the Comprehensive Lung Center at UPMC Shadyside. "Many people with severe emphysema will now be able to take advantage of Medicare coverage for this procedure."

Eligibility for Medicare coverage is restricted to those institutions that perform lung transplant surgery and participated in the National Emphysema Treatment Trial (NETT) study, the first multi-center clinical trial of LVRS for emphysema.

Medicare coverage for LVRS includes patients who are non high-risk and present with severe, upper-lobe emphysema, or non high-risk and present with severe, non upper-lobe emphysema with low exercise capacity. The surgery must be preceded and followed by a program of diagnostic and therapeutic services consistent with those provided in the NETT study and designed to maximize the patient's potential to successfully undergo and recover from surgery. The program must include a six- to 10-week series of at least 16 preoperative sessions, each lasting a minimum of two hours. It must also include at least six postoperative sessions, each lasting a minimum of two hours, within eight to nine weeks of LVRS. The pre-surgery evaluation will include cardiopulmonary exercise testing, complete lung volumes and six-minute walking testing.

For more information, call 412-647-3555 or visit www.upmc.com.

— University of Pittsburgh Medical Center