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

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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, and Marge Watchorn, deputy director of the Division of Practitioner Services. ISASS had met with the same set of officials on October 22, 2018, on the same issue.

ISASS presented information regarding the mis-valuation of minimally invasive spine surgical services in the Medicare Physician Fee Schedule and the increased costs and decreased patient benefits that result from these errors in valuation. The meeting was an important opportunity for ISASS to continue to advocate for proper payment for efficacious and less invasive spine surgery options on behalf of patients suffering from spine and disc conditions and seeking a full array of treatment options that best suit their needs as patients.

CMS officials indicated a significant interest in collaborating with ISASS to improve care for Medicare beneficiaries and invited Dr. Lorio and others to continue to regularly interact and continue their dialogue with them in future rule-making comment letters and face-to-face meetings.