Public Policy

February 26, 2019

AMA CPT Editorial Panel Issues Draft Updated Evaluation and Management (E/M) Codes

The AMA CPT Editorial Panel approved draft changes to a series of Evaluation and Management (E/M) service CPT codes at its February 2019 CPT Editorial Panel meeting attended by ISASS representatives.  The changes had been developed by a Joint Workgroup of AMA CPT and AMA RUC members, which held multiple stakeholder calls and meetings across a series of months.  These calls and meetings were attended by ISASS CPT Advisor Dr. James Yue and ISASS Alternate CPT Advisor Dr. Morgan Lorio.  The code change proposals are intended to make it easier to document patient visits and reduce regulatory burden on physician and physician staff. In the next few weeks, medical societies will be conducting AMA/Specialty Society RVS (Relative Value Scale) Update […]
February 26, 2019

ISASS Publishes Policy Statements on Bone Graft Procedures and Vertebral Augmentation

ISASS has published a new policy statement on Bone Grafting procedures and an updated policy on Vertebral Augmentation. These policies are based on review by clinical experts and reviewed and published in the International Journal of Spine Surgery, the official ISASS journal, in February 2019. Links to the policy statements can be found on the ISASS website. Bone Graft Policy Updated Vertebral Augmentation Policy
February 26, 2019

Centers for Medicare and Medicaid Services (CMS) Make Hospital Charges Available to the Public

For the first time, the federal government has made public chargemaster data for the 100 most common Medicare inpatient diagnostic related groups or DRGs. The data show that hospital prices often vary widely, even within the same within the same city or region. The massive file contains chargemaster data, or what some call the “sticker price,” for the 100 most common Medicare inpatient DRGs. The data does not include physician costs and does not show prices paid by Medicare. But it does provide an inside look at how average covered Medicare charges can significantly vary from hospital to hospital within the same city or geographic area. The data is for 3,400 hospitals and represents 92% of all hospital inpatient charges in […]
February 26, 2019

ISASS Meets with CMS Officials Regarding Reimbursement of Minimally Invasive Spine Surgery

ISASS Coding and Reimbursement Task Force Chair Dr. Morgan Lorio participated in a meeting with officials from Centers for Medicare & Medicaid Services, or CMS, to discuss reimbursement of minimally invasive spine surgery procedures in the Medicare Physician Fee Schedule.  The meeting occurred February 6, 2019, and was focused primarily on CPT code 27279, Minimally Invasive Sacroiliac Joint Fusion, which CMS has identified as potentially mis-valued in previous Medicare Physician Fee Schedules. CMS was represented by Director Carol Blackford; Ing-Jye Cheng, deputy director for the Office of the Department of Hospital and Ambulatory Policy Group (HAPG); and other officers in the Outpatient Care, Practitioner Services and Ambulatory Services Divisions, including Gift Tee, acting director of the Division of Practitioner Services, […]