January 31, 2017

ISASS Policy & Advocacy News – January 2017

News and noteworthy information for January 2017: A Closer Look at Biomechanical Device Coding MACRA/QPP Survey Global Surgery Data Collection Program Finalized Judge Blocks Aetna-Humana Merger Price Testifies at Senate Confirmation Hearings ICD-10 Code Updates and Impact to PQRS FDA Reclassifies Pedicle Screw Systems   A Closer Look at Biomechanical Device Coding Effective January 1, 2017, CPT® code 22851was deleted from the CPT code set and replaced by three new codes to report insertion of biomechanical devices: CPT Code 22853 – Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for […]
January 31, 2017

ISASS Submits Comments to Anthem BCBS on Coding Edits

On January 31, ISASS submitted comments to Anthem Blue Cross Blue Shield (BCBS) regarding two sets of coding edits, one set implemented in September 2015 and another set scheduled for implementation on March 1, 2017. The coding edits bundle: laminectomy codes 63042, 63047 and 63048 with lumbar fusion codes 22630 and 22633 additional level posterior/posterolateral fusion code 22614 with codes 22600, 22610, 22612, 22630 and 22633 vertebral corpectomy codes 63081, 63082, 63085, 63086, 63087 and 63088 with lumbar fusion code 22558 These coding edits mean that surgeons will only be reimbursed by Anthem BCBS for the primary procedure and will no longer be reimbursed by Anthem BCBS for the bundled procedure. ISASS strongly opposes these coding edits and has requested Anthem BCBS retract […]
January 1, 2017

Code Change Requests

Code Change Requests Coding Cycle Code changes for all medical specialties take effect on January 1 annually as a result of the CPT Editorial Panel process. The American Medical Association (AMA) is responsible for Current Procedural Terminology (CPT) and has convened the CPT Editorial Panel to develop and maintain the nomenclature healthcare providers use to report medical procedures and services. The CPT Editorial Panel meets three times a year to evaluate code change proposals for new and emerging technology and is responsible for reorganizing and maintaining the code set. After codes are created or modified by the CPT Editorial Panel, they go before the Relative Value Update Committee (RUC), also convened by the AMA, to be valued. For more information […]
December 31, 2016

ISASS Policy & Advocacy News – December 2016

Wishing you a happy and healthy 2017 from all of us at ISASS!   News and noteworthy information for December 2016: MACRA/QPP Survey ISASS Issues Policy Statement on Decompression with Interlaminar Stabilization President-Elect Trump Selects Congressman Price as HHS Secretary Congress Passes 21st Century Cures Act   MACRA/QPP Survey The Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) was bipartisan legislation signed into law in April 2015 to permanently repeal the Sustainable Growth Rate (SGR), streamline physician quality reporting programs, and provide incentive payments for physician participation in alternative payment models. MACRA sunsets the Physician Quality Reporting System (PQRS), the Value-Based Payment Modifier, and the Medicare Electronic Health Record (EHR) Incentive Program and establishes an umbrella Quality Payment Program (QPP) […]