CMS Issues Proposed Rule for 2021 Medicare Physician Fee Schedule: Specific Impact to Spine Procedures CMS Issues Proposed Rule for 2021 Medicare Physician Fee Schedule: Specific Impact to Spine Procedures Published by Machelle Morningstar, CPC, COC, CEMC, COSC, August 4, 2020 PHYSICIAN PAYMENT PROVISIONS The 2021 Proposed Medicare Physician Fee Schedule Rule updated several policies and payment rates of relevance to ISASS members. Notably, budget neutrality adjustments have reduced the Conversion Factor associated with all CPT codes, from $36/RVU to $32/RVU. This, along with other code-specific adjustments, has impacted spine procedures by decreasing Medicare payments between 5% and 12%, compared with CY 2020 Final rates. Public comments are being accepted by CMS between now and 5pm eastern on October 5th, […]
Read the Summer 2020 issue of “Vertebral Columns” This edition includes the following: Editorial: Inappropriate Denial of Spine Surgery Claims: Implications for Patients, Physicians & Payers Complications: Identifying the Complication Profile Related to Cervical Disc Replacement: Going Beyond IDE Studies Clinical Practice: Epidural Steroid Injections: Do They Work? And Do They Increase Infection Rates With Surgery Clinical Practice: Physical Therapy After Lumbar Spine Surgery Medical Education: Telehealth and Resident Training: Optimizing “Webside Manner” Recommendations: Mattresses, Pillows, and Sleep Position: What Do the Data Actually Support? Physician Burnout: Peer-to-Peer? Medical Necessity? Prior Authorization? How the Insurance Companies’ Medical Claims Approval Process Is Causing Physicians to Burn Out and Patients to Lose Out Download the full issue here or view below.
ISASS Comments on Washington State Health Care Authority Potential Review of Sacroiliac Joint Fusion Policy On July 23, 2020, ISASS sent a comment letter to the Washington State Health Care Authority (HCA) regarding their sacroiliac joint fusion coverage policy, which is used by the state’s Medicaid and workers’ compensation program for coverage. The ISASS letter asked that the Washington HCA consider review and potential revision of their coverage policy to include minimally invasive sacroiliac joint fusion for joint pain and dysfunction due to degenerative conditions not limited to direct trauma or injury to the pelvic girdle, which would be consistent with ISASS recommendations. The current Washington State HCA policy does not recommend coverage, despite an initial positive finding by the […]
ISASS-Endorsed CPT Application is Approved at May 2020 CPT Editorial Panel Meeting At the American Medical Association Current Procedural Terminology (CPT) Editorial Panel meeting, held virtually May 12-14, 2020, ISASS co-sponsored an application for new Category III (emerging technology) codes to report fluoroscopic and computed tomographic guided percutaneous injection of allogenic cellular and/or tissue-based product. The application was accepted by the Editorial Panel and will be released as Category III in January 2021 for use in the CPT code set. Dr. James Yue, ISASS CPT Advisor, and Dr. Morgan Lorio, ISASS CPT Alternate Advisor, were presenters for the meeting, along with Dr. Douglas Beall, one of the clinical investigators for the new technology. Read the summary of action items from […]