July 30, 2019

CMS Proposes to Maintain Current Value for Minimally Invasive SI Joint Spine Fusion But Will Consider Alternative Values

In the July 29, Medicare Physician Fee Schedule Proposed Rule, CMS indicated a proposed value for CPT code 27279, Arthrodesis, sacroiliac joint, percutaneous or minimally invasive (indirect visualization), with image guidance, includes obtaining bone graft when performed, and placement of transfixing device of 19.88 Total RVUS which maintains the current value of 27279. ISASS had previously asked CMS to reconsider the value of this CPT code as “misvalued,” and CMS agreed that it may be misvalued and assigned a review of the value by the AMA RUC.  ISASS, along with other medical societies—icluding NASS, AANS, and AAOS—conducted a physician survey and recommended increasing the RVUs for 27279.  The RUC, however, did not accept this recommendation and CMS cited the RUC’s […]
June 25, 2019

ISASS Urges Changes to NCCI Edits for Spine Surgery

In a letter dated June 11,  ISASS provided additional input and reiterated its request from April 18,  for CMS to consider changes to a set of National Correct Coding Initiative (NCCI) edits for CPT codes 22842, Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure), 22843, Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure), 22844, Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more vertebral segments (List separately in addition to code for […]
April 30, 2019

ISASS Asks For Changes to National Correct Coding Initiative (NCCI) edits for Spinal Instrumentation Codes

In a letter dated April 16, 2019, ISASS asked for CMS to consider changes to a set of National Correct Coding Initiative (NCCI) edits for CPT codes 22842, Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure), 22843, Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure), 22844, Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more vertebral segments (List separately in addition to code for primary procedure) 22845, Anterior instrumentation; 2 to 3 […]
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 […]