Nikki Golden

June 25, 2019

ISASS Urges Changes to NCCI Edits for Spine Surgery

In a letter dated June 11,  ISASS provided additional input and reiterated its request from April 18,  for CMS to consider changes to a set of National Correct Coding Initiative (NCCI) edits for CPT codes 22842, Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure), 22843, Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure), 22844, Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more vertebral segments (List separately in addition to code for […]
May 29, 2019

UPDATED: MAC Carrier Noridian Healthcare Publishes Carrier Advisory Committee (CAC) Voting Results for Vertebral Augmentation Policy

In April, Medicare Administrator Contractor (MAC) carrier Noridian published Carrier Advisory Committee (CAC) Voting Results for a draft policy on Vertebral Augmentation. The CAC meeting took place in March based on a draft policy that had been previously published. Several providers and specialty societies provided input to Noridian and the CAC members on clinical standards and current literature for Vertebral Augmentation, including ISASS through a letter sent to Noridian. The letter was reviewed by the CAC for the March meeting. The CAC process is used by Medicare Administrator Contractors such as Noridian to review clinical literature on new and emerging technologies under consideration for payment policies for various Medicare jurisdictions. CAC members are drawn from the physician community for each […]
May 29, 2019

Specialty Societies, CMS Convenes a Listening Session on Opioid Use Disorder Treatment

On May 21, CMS held a listening session on Opioid Use Disorder Treatment to solicit feedback from those prescribing opioids and those providing treatment for opioid use disorder. The Center for Medicare and Medicaid Innovation (Innovation Center) hosted the 90-minute virtual Listening Session to inform development of an opioid use disorder (OUD) treatment demonstration program created through the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act. The listening session focus included: Obtaining input from providers and other stakeholders into the design of the demonstration program, including performance-based incentive payments. Identifying and understanding what the biggest barriers to increasing access to and utilization of OUD treatment are, in a post-SUPPORT Act era. Assessment and understanding […]
May 29, 2019

UPDATE: Specialty Societies Provide Input on Updates to Medicare Quality Payment Program, and Submit Letter to Members of Congress

In May, a group of national medical specialty societies provided input to federal lawmakers and regulators on steps to improve the Medicare Quality Payment Program (QPP). In a document released to U.S. Members of Congress and to administrators with the U.S. Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS), the societies outlined several areas where lawmakers and regulators could improve the current Medicare QPP. The QPP is intended to provided payment and incentives to healthcare providers for improving quality and value to patients. Among the recommendations were updates to the Merit-based Incentive Payment System (MIPS) under QPP and the Alternative Payment Model (APM) system under QPP. For MIPS, recommendations included: Provide scoring flexibility to […]