- Have any questions?
- +1-630-375-1432
- info@isass.org
Policy and Advocacy News
- Filter by
- Categories
- Tags
- Authors
- Show all
- All
- Advocacy Alerts
- Annual Meeting
- News
- Policy and Advocacy News
- Policy Statements
- Press Releases
- Public Policy
- Vertebral Columns
- All
- abstract submission
- advocacy
- AMA House of Delegates
- AMA RUC
- Anti-kickback statute
- Arthroplasty
- ASC
- Barricade Implant System
- Basivertebral nerve
- Blue Cross Blue Shield
- bone graft
- bone graft substitutes
- bone grafts
- C-code
- CAHs
- cervical disc replacement
- chronic low back pain
- CME
- CMS
- CPT 27279
- CPT codes
- discectomy
- discharge planning
- DMEPOS
- drug pricing
- E/M Services
- education
- Electronic health records
- endoscopic
- executive order
- FDA
- HAC Reduction Program
- HELP
- HHAs
- HHS
- HIPPA
- Hospital readmission reduction program
- innovative technologies
- IPPS
- IRF
- IRF Quality Reporting Program
- ISASS guideline
- ISASS news
- ISASS pol
- ISASS policy guideline
- ISASS Policy Statements
- ISASS19
- ISASS20
- LTCH
- lumbar disc herniation with radiculpathy
- lumbar disc replacement
- Medicaid
- Medicaid oversight
- Medicare
- Medicare chargemaster
- Medicare Physician Fee Schedule
- Medicare Quality Payment Program
- minimally invasive
- minimally invasive SI Joint surgery
- MIPS
- MIS SIJ fusion
- Misvaluation
- NCCI
- Office of Management and Budget
- Open Payments Program
- opiod alternatives
- opiods
- OPPS
- patients over paperwork
- Patients over paperwork initiative
- Payment models
- payment systems
- policy
- PPS
- price transparency
- prior authorization
- Puerto Rico
- quality measurement
- RUC
- Sacroiliac Joint Fusion
- scientific research
- SI Joint
- Si Joint Fusion
- spine research
- Stark Law
- surgical staplers
- surprise billing
- vertebral augmentation
- White House Executive Order
March 28, 2019
Published by Nikki Golden at March 28, 2019
Categories
A recent convening of Alabama BCBS’ Medical Policy Group proposed a positive change to their policy on Minimally Invasive SI Joint Surgery to establish MIS SIJ fusion as medically necessary using an FDA-approved device (not specific to any one device type) when all of the following criteria are met: Pain is at least 5 on a 0 to 10 rating scale that impacts quality of life or limits activities of daily living; AND There is an absence of generalized pain behavior (e.g., somatoform disorder) or generalized pain disorders (e.g., fibromyalgia); AND Patients have undergone and failed a minimum six months of intensive non-operative treatment that must include medication optimization, activity modification, bracing, and active therapeutic exercise targeted at the lumbar spine, pelvis, sacroiliac joint, and […]
March 28, 2019
Published by Nikki Golden at March 28, 2019
Categories
ISASS Coding and Reimbursement Task Force Chair Dr. Morgan Lorio participated in a meeting with officials from the Office of Management and Budget (OMB) to discuss reimbursement of minimally invasive spine surgery procedures in the Medicare Physician Fee Schedule. The meeting occurred March 19, 2019, and was focused on the undervaluation of spine surgical procedures in the Medicare Physician Fee Schedule. Dr. Lorio described two clear examples of mis-valuation of minimally invasive spinal procedure in CPT code 27279, Minimally Invasive Sacroiliac Joint Fusion, and 22867, Interlaminar Spinal Stabilization. The Centers for Medicare and Medicaid Services (CMS) have already identified as potentially misvalued in previous Medicare Physician Fee Schedules but have not changed the Relative Value Units (RVUs) for 27279. OMB […]
March 28, 2019
Published by Nikki Golden at March 28, 2019
Categories
The International Society for the Advancement of Spine Surgery released two new statements: one focused on bone graft substitutes and the other examining vertebral augmentation. The bone graft substitute statement outlines historical use and U.S. regulatory pathways for bone grafts, including nonstructural allografts, demineralized bone grafts, cellular-based allografts, synthetic bone grafts, autologous cellular grafts and Class III drug-device combination products. “Bone grafting is an essential part of spinal surgery and ever-evolving science,” concluded the recommendation authors. “With each new advance, one needs to understand the characteristics of material, its mechanism of action, the regulatory pathway by which it came to market and the preclinical and human clinical evidence available on which to base a clinical use decision.” The authors found: Nonstructural cancellous allograft […]
February 26, 2019
Published by Nikki Golden at February 26, 2019
Categories
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 […]