On July 13, 2017, the Centers for Medicare & Medicaid Services (CMS) released the 2018 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System policy changes, quality provisions, and payment rates proposed rule. CMS is accepting comments on the proposed rule through September 11, 2017. The final rule is expected to be released by November 1, 2017. (Please note that physician payment is made under the Physician Fee Schedule; hospitals are paid for outpatient services under the OPPS and ASCs are paid under the ASC payment system, both detailed in this rulemaking.) Please see the spine code spreadsheet for a comprehensive comparison of reimbursements for spine procedures in both the Hospital Outpatient and ASC settings from […]
On July 13, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that updates payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2018. The PFS pays for services furnished by physicians and other practitioners in all sites of service. These services include but are not limited to visits, surgical procedures, diagnostic tests, therapy services, and specified preventive services. CMS will accept comments on the proposed rule until September 11, 2017, and will issue the final rule by November 1, 2017. As part of the proposed rule, CMS issues proposed values for new codes and codes deemed misvalued. Please see the spine code spreadsheet […]
On June 22, ISASS submitted a letter to Hayes in response to a Hayes Brief released December 29, 2016 reviewing sacroiliac joint fusion for treatment of low back pain. ISASS requested a meeting with Hayes to discuss the most current literature on the procedure as many of our members and their patients have experienced denials by insurers based on the Brief and its “C” rating.
Registration is now open for the ISASS The Role of Arthroplasty and Non-Fusion in 2017: Use it or Lose Patients! Controversy and Cadavers Course being held November 3-4, 2017 in Miami, FL, US. Course Description This is is a two-day hands-on course for surgeons. There is an increasing amount of international data, particularly from US FDA prospective randomized studies, that provides consistent support for the role of spine arthroplasty and non-fusion technologies towards improving outcomes and quality of life in well selected patients. It is important for spine surgeons to be aware of this data, so they can educate their patients, other health care providers, and payors as to the Level I evidence available. Combined with clinical experience from around the […]