ISASS Comments on Independence Blue Cross Spinal Fusion Policy On August 25, 2020, ISASS sent a comment letter to Independent Blue Cross (IBC), the Blue Cross affiliate for the Greater Philadelphia area, regarding their recent Spinal Fusion Policy. The IBC policy calls for attestation of failure of conservative treatment by a physiatrist. The letter from Dr. Frank Phillips, ISASS president, stated “ISASS believes that this intrusion has already been shown to create significant barriers to efficient care. ISASS questions the Level of Evidence supporting an additional consultation with a physiatrist to document that a patient has exhausted nonsurgical options. ISASS further maintains that the spine surgeon, rather than the physiatrist, is solely capable of the surgical decision making required to […]
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.