Neurosurgery Coding Alert

Some fret over potential impact on payments for procedure
 
At the behest of Medicare, an advisory panel of physicians met in early December to discuss the merits of spinal fusion surgery to treat chronic lower back pain.

According to a Reuters story on the Medscape.com Web site, the panel is weighing the procedure's effectiveness, especially for older patients. Medicare insists that it is not reassessing its current policy of paying for the service, but some industry analysts think the meeting could lead Medicare to reconsider covering the procedure at all.

-This [review process] is to gather evidence,- said Steve Phurrough, director of coverage for CMS.

The meeting was prompted by recent studies that question whether spinal fusion is better than exercise and rehabilitation for patients.

-The evidence for lumbar spinal fusion does not conclusively demonstrate short-term or long-term benefits compared with nonsurgical treatment,- government experts said in a draft assessment of available data, according to Reuters.

Codes affected: The codes that represent spinal fusion surgery, which Medicare now pays for, are:

- 22558 -- Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar

- 22612 -- Arthrodesis, posterior or posterolateral technique, single level; lumbar (with or without lateral transverse technique)

- 22630 -- Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression),  single interspace; lumbar.
 
At press time, the outcome of the meeting was not known. But look to future issues of Neurosurgery Coding Alert for more information on this coverage issue.