August 12, 2020

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 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, […]
August 7, 2020

ISASS Comments on Washington State Health Care Authority Potential Review of Sacroiliac Joint Fusion Policy

ISASS Comments on Washington State Health Care Authority Potential Review of Sacroiliac Joint Fusion Policy On July 23, 2020, ISASS sent a comment letter to the Washington State Health Care Authority (HCA) regarding their sacroiliac joint fusion coverage policy, which is used by the state’s Medicaid and workers’ compensation program for coverage. The ISASS letter asked that the Washington HCA consider review and potential revision of their coverage policy to include minimally invasive sacroiliac joint fusion for joint pain and dysfunction due to degenerative conditions not limited to direct trauma or injury to the pelvic girdle, which would be consistent with ISASS recommendations. The current Washington State HCA policy does not recommend coverage, despite an initial positive finding by the […]
August 7, 2020

ISASS-Endorsed CPT Application is Approved at May 2020 CPT Editorial Panel Meeting

ISASS-Endorsed CPT Application is Approved at May 2020 CPT Editorial Panel Meeting At the American Medical Association Current Procedural Terminology (CPT) Editorial Panel meeting, held virtually May 12-14, 2020, ISASS co-sponsored an application for new Category III (emerging technology) codes to report fluoroscopic and computed tomographic guided percutaneous injection of allogenic cellular and/or tissue-based product. The application was accepted by the Editorial Panel and will be released as Category III in January 2021 for use in the CPT code set. Dr. James Yue, ISASS CPT Advisor, and Dr. Morgan Lorio, ISASS CPT Alternate Advisor, were presenters for the meeting, along with Dr. Douglas Beall, one of the clinical investigators for the new technology. Read the summary of action items from […]
August 7, 2020

ISASS Supports Letter to the HHS Requesting Elimination of Budget Neutrality Adjustments to Physician Payments for 2020

ISASS Supports Letter to the HHS Requesting Elimination of Budget Neutrality Adjustments to Physician Payments for 2020 On July 1, 2020, multiple organizations, including ISASS, sent a letter to Alex Azar, secretary of Health and Human Services (HHS), to remove budget neutrality negative adjustments under the 2021 Medicare Physician Fee Schedule. The organizations indicated support for the actions of the Centers for Medicare and Medicaid Services (CMS) in last year’s Medicare physician payment final rule to utilize the American Medical Association (AMA) Current Procedural Terminology Editorial Panel coding framework, and the AMA Specialty Society Relative Value Scale Update Committee recommended values for office and outpatient visits starting January 1, 2021. The framework was the result of significant collaboration by an […]