On March 24, ISASS sent a letter to the Work Loss Data Institute requesting an update to the outdated Official Disability Guidelines for Sacroiliac Joint (SIJ) pain. ISASS takes issue with the current guidelines which support minimally invasive sacroiliac joint (MIS SIJ) fusion for conditions such as SIJ infection, tumor, and spondyloarthropathy, conditions for which high-quality evidence supporting superiority over non-surgical treatment is completely lacking. The guidelines dismiss two high-quality randomized trials in patients with chronic SIJ dysfunction showing superiority of MIS SIJ fusion over non-surgical treatment. ISASS requests revision of the guidelines to better reflect the level of available evidence and to follow standard scientific approaches to evidence interpretation. Click here to view the letter.
News and noteworthy information for January 2017: A Closer Look at Biomechanical Device Coding MACRA/QPP Survey Global Surgery Data Collection Program Finalized Judge Blocks Aetna-Humana Merger Price Testifies at Senate Confirmation Hearings ICD-10 Code Updates and Impact to PQRS FDA Reclassifies Pedicle Screw Systems A Closer Look at Biomechanical Device Coding Effective January 1, 2017, CPT® code 22851was deleted from the CPT code set and replaced by three new codes to report insertion of biomechanical devices: CPT Code 22853 – Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for […]
On January 31, ISASS submitted comments to Anthem Blue Cross Blue Shield (BCBS) regarding two sets of coding edits, one set implemented in September 2015 and another set scheduled for implementation on March 1, 2017. The coding edits bundle: laminectomy codes 63042, 63047 and 63048 with lumbar fusion codes 22630 and 22633 additional level posterior/posterolateral fusion code 22614 with codes 22600, 22610, 22612, 22630 and 22633 vertebral corpectomy codes 63081, 63082, 63085, 63086, 63087 and 63088 with lumbar fusion code 22558 These coding edits mean that surgeons will only be reimbursed by Anthem BCBS for the primary procedure and will no longer be reimbursed by Anthem BCBS for the bundled procedure. ISASS strongly opposes these coding edits and has requested Anthem BCBS retract […]
Code Change Requests Coding Cycle Code changes for all medical specialties take effect on January 1 annually as a result of the CPT Editorial Panel process. The American Medical Association (AMA) is responsible for Current Procedural Terminology (CPT) and has convened the CPT Editorial Panel to develop and maintain the nomenclature healthcare providers use to report medical procedures and services. The CPT Editorial Panel meets three times a year to evaluate code change proposals for new and emerging technology and is responsible for reorganizing and maintaining the code set. After codes are created or modified by the CPT Editorial Panel, they go before the Relative Value Update Committee (RUC), also convened by the AMA, to be valued. For more information […]