The increased number of U.S. residents undergoing spine-care treatment, coupled with emerging medical developments in the field, has spurred the North American Spine Society (NASS) to revise its coverage policy recommendations for common treatments, procedures and diagnostics of the spine.
“Maintaining patient access to high-quality, evidenced-based and ethical spine care is the single most important part of NASS’ mission,” said William Watters III, MD, MMS, MS. “It is our hope that payers, spine specialists and their patients will use these evidence-based coverage recommendations as a reference to advocate for appropriate care for patients.”
NASS policy recommendations are now available on cervical artificial disc replacement, endoscopic discectomy, epidural cervical spinal injections, interspinous device without fusion, interspinous fixation with fusion, laser spine surgery, lumbar artificial disc replacement, lumbar discectomy, lumbar fusion, lumbar laminotomy, lumbar spinal injections, percutaneous thoracolumbar stabilization and recombinant human bone morphogenetic protein (rhBMP-2).
The aging population is one factor in the increase of spinal procedures. “As patients with chronic conditions receive better care that enables them to live longer, increasing numbers of older patients are now undergoing cervical spine surgeries,” noted Dr. Kern Singh, MD, in an article for the American Academy of Orthopaedic Surgeons.
According to the organization, the NASS board of directors created a multi-specialty team to focus on defining appropriate coverage positions to assist payers, physicians and their patients on fair coverage for spine care. NASS based the recommendations on extensive literature research while incorporating existing NASS health policy comments and evidence-based guidelines.
Each recommendation reportedly provides the scope and clinical indications for a particular treatment or procedure. It also describes the circumstances for which that particular treatment or procedure is not indicated. Finally, the policy recommendation provides the rationale for coverage or non-coverage of a treatment or procedure, complete with references for further review.
The task force will continue to develop additional coverage recommendations, including annular repair, cervical and lumbar radiofrequency neurotomy, cervical fusion, cervical laminectomy, cervical laminoplasty, interspinous fusion with implant, intradiscal coblation treatments, lumbar laminectomy, lumbar laminotomy/foraminotomy, minimally invasive lumbar fusion, percutaneous laminectomy (e.g., MILD), perineural lumbar spinal injections, SI joint fusion, SI joint injections (therapeutic and diagnostic), DNA-based scoliosis test and electrical stimulation for bone healing.
Edited by
Rory J. Thompson
