Public Policy

August 7, 2013

Statement on Coding Changes for Minimally Invasive SI Joint Fusion

ISASS supports decision making at the physician-patient level based on medical necessity and achieving the best outcomes to address the patient’s medical condition. Medical necessity should not be determined by a mere administrative code reporting system such as CPT. Prior to the July 1st implementation of CPT category III code 0334T, surgeons reported and were reimbursed for ALL sacroiliac joint fusion procedures when medically necessary, including minimally invasive, through the use of CPT code 27280. To determine procedural approach prevalence associated with CPT code 27280, ISASS and the Society of Minimally Invasive Spine Surgeons conducted a survey of surgeons, and found that in 2012, nearly 90 percent of all SIJ fusions were performed using a minimally invasive approach. Yet despite […]
May 20, 2013

Domagoj Coric, MD Responds to BCBSNC “Let’s Talk Cost” Statement on Artificial Discs

May 20, 2013 Don W Bradley, MD, MHS-CL Vice-President for Healthcare and CMO Blue Cross and Blue Shield of North Carolina P.O. Box 2291 Durham, NC 27702 Dear Dr. Bradley: I am writing you on behalf of International Advocates for Spine Patients (IASP) as well as the patient population of North Carolina. IASP is an organization supported by physicians and patients dedicated to advocacy for high quality, widely accessible and cost effective spine care for patients around the world. I am on the Board of IASP (a sister organization to the International Society for the Advancement of Spine Surgery-ISASS) which was formed in 2011 to complement ISASS’ educational and scientific mission through direct advocacy efforts on the behalf of spine […]
March 18, 2013

ISASS Policy Statement – Vertebral Augmentation

ISASS Policy Statement – Vertebral Augmentation It is estimated that over 1.4 million people will develop vertebral compression fractures every year (Johnell & Kanis 2006).  Many will be clinically insignificant or heal with non-operative treatment.  A large group will have persistent pain, kypholic deformity, weight loss, depression and a reduced quality of life.  (Old & Calvert 2004; Borgstrom et al. 2006; Suzuki et al. 2008). Open surgical intervention is used when there is severe deformity, instability, or neurologic compromise. Vertebral augmentation such as Vertebroplasty (VP) and balloon kyphoplasty (BKP) are minimally invasive techniques used to treat painful vertebral compression fractures.  There is good evidence that these techniques can provide immediate and lasting pain relief (Berlemann et al. 2004; Grafe et […]
December 6, 2012

Federal AHRQ to Review Comparative Effectiveness for Spinal Fusion

Note: The public comment period for this has passed. Thank you for your input. Member Input Needed The US Agency for Healthcare Quality and Research (AHRQ) has taken up a comparative effectiveness review of “Spinal Fusion for Treating Painful Lumbar Degenerated Discs or Joints.” They recently released a draft report and have provided a public comment period with a deadline of December 18, 2012. A draft report and report appendix can be found here: Comment on Draft Reports and White Papers ISASS is encouraging our members to provide comments to AHRQ. AHRQ reports are not definitive policy for either Medicare/Medicaid or commercial insurers. However, commercial insurers oftentimes cite AHRQ reports to support their policies. AHRQ states that “The information in this report […]