Public Policy

March 4, 2016

AMA Posts CPT Editorial Summary of Panel Actions

On March 4, the American Medical Association posted the CPT® Editorial Summary of Panel Actions, a high-level summary of the final actions taken by the CPT® Editorial Panel at the February 2016 meeting. Tab 43 addressed the sundowning of several Category III codes. Category III codes are archived five years from the date of initial publication or extension unless a modification of the archival date is specifically noted at the time of a revision or change to a code. Along with several other codes, the CPT® Editorial Panel accepted the archiving of 0309T (Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft, when performed, lumbar, L4-L5 interspace (List separately in addition to code for primary procedure)). Category […]
February 29, 2016

ISASS Policy & Advocacy News – February 2016

News and noteworthy information for February: NGS Issues Final LCD on MIS SIJ Fusion Califf Confirmed as FDA Commissioner FDA Looks to Bring Payers to the Table at Device Pre-submission Meetings President Obama Releases Proposed Budget for FY2017 Senate HELP Committee Action Public-Private Partnership to Develop Health Care Quality Measures CMS Extends the Attestation Deadline for the EHR Incentive Programs Medicare Final Rule – Reporting and Returning of Self-Identified Overpayments Research & Reimbursement Course Scheduled for ISASS16   NGS Issues Final LCD on MIS SIJ Fusion NGS Medicare, the Medicare Administrative Contractor covering 9.5 million Medicare beneficiaries in Illinois, Minnesota, Wisconsin, Connecticut, New York, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont recently finalized its Local Coverage Determination (LCD) for […]
February 23, 2016

ISASS Signs on to APAM Letter to Congress in Support of Reauthorization of NASPER

ISASS signed on to a letter to Congress authored by the Alliance to Prevent the Abuse of Medicines (APAM) in support of the reauthorization of NASPER, the federal program providing support for state Prescription Drug Monitoring Programs. APAM is a multi-stakeholder coalition composed of representatives of each industry involved in the manufacture, distribution, payment, prescribing and dispensing of pharmaceuticals and is focused on building consensus and promoting solutions to our nation’s opioid abuse epidemic. Letter to Congress
February 18, 2016

ISASS Sends Letter to Aetna in Support of Coverage of Cages in Cervical Fusion

In a letter to Aetna, ISASS expressed concern with Section IX – Intervertebral Body Fusion Devices (Spine Cages) of Aetna Back Pain – Invasive Procedures Policy Number 0016 (“Policy”). Section IX of the Policy allows coverage of cages for cervical fusion under the following indications: A. Multilevel (three or more vertebral bodies) corpectomy (removal of half or more of vertebral body, not mere removal of osteophytes and minor decompression) in the treatment of one of the following: 1. for tumors involving one or more vertebrae, or 2. greater than 50 percent compression fracture of vertebrae, or 3. retropulsed bone fragments, or 4. central canal stenosis with myelopathy. B. Multilevel (three or more vertebral bodies) fusion for pseudarthrosis in persons with […]