Spine Surgery Societies’ Statement on Prior Authorization

In June 2022, a coalition of more than a dozen specialty societies, including ISASS, issued a consensus statement on the use of imaging requirements for Prior Authorization.

The letter states:

Position Statement

The doctor-patient relationship is an indispensable component of shared decision-making in choosing to undergo spine surgery. This choice must remain the purview of the patient and the surgeon. Using imaging studies in isolation, without clinical context, may undermine appropriate clinical diagnosis and treatment plans. The concept that image sharing should be a basis for prior authorization is an unnecessary and unwelcome impingement on the doctor-patient relationship, which will detrimentally interfere with the decision for spine surgery. Physicians who treat spine conditions adamantly oppose requiring the submission of patient images as a prior authorization requirement for spine surgery.


Radiologists play a vital role in health care. However, radiologists have neither seen nor examined the patient, and therefore, the radiology report itself cannot be the arbiter of clinically-meaningful spinal pathology. Furthermore, it is inappropriate for a non-spine surgeon — whether a radiologist, nurse or

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