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Coding & Reimbursement Task Force Tackles Growing List of Issues, Welcomes Input In response to continued downward pressure from government and commercial payers on spine surgery coverage and reimbursement, the ISASS Coding & Reimbursement Task Force continues to evaluate policies that may be detrimental to optimal patient care, and that may unnecessarily or punitively reduce physician reimbursement.  Under the leadership of Chairman Morgan Lorio, MD, the Task Force’s work is seemingly endless; in July, the Task Force issued a statement on coding for SI joint fusions, following changes issued by the CPT Editorial Panel, effective July 1st. The new category III code to be used for minimally invasive SI joint fusion may cause confusion with physician offices, and could lead […]

Download in PDF Format » Marilyn B. Tavenner Administrator Centers for Medicare & Medicaid Services 200 Independence Avenue, SW Hubert H. Humphrey Building Washington, DC 20201 RE: CMS Proposed Rule (CMS-1601-P) Section III(A) Regarding Changes to IDE Coverage Process Dear Ms. Tavenner: On behalf of the International Society for the Advancement of Spine Surgery (ISASS), below are comments submitted on CMS’ Proposed Rule, Revisions to Payment Policies under the Physician Fee Schedule, Clinical Laboratory Fee Schedule and Other Revisions to Part B for CY 2014. ISASS is an international, scientific and educational society organized to discuss and assess existing strategies and innovative ideas in the clinical and basic sciences related to spine surgery to enhance patient care. Our comments focus specifically […]

Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Medicare Part B for CY 2014 Download in PDF Format » Marilyn B. Tavenner Administrator Centers for Medicare & Medicaid Services 200 Independence Avenue, SW Hubert H. Humphrey Building Washington, DC 20201 RE: CMS Proposed Rule (CMS-1600-P) – Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Medicare Part B for CY 2014 Dear Ms. Tavenner: On behalf of the International Society for the Advancement of Spine Surgery (ISASS), I am writing to submit comments on the proposed Medicare Physician Fee Schedule (MPFS) for CY 2014. ISASS is an international, scientific and educational society organized to discuss and assess existing strategies and innovative […]

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 […]