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CMS won't delay prior authorizations for outpatient cervical fusions

By Admin | July 31, 2021

CMS forged ahead July 1 with a prior authorization requirement for cervical fusion procedures despite protest from several organizations.

The agency revealed in December it planned to require prior authorization for cervical fusion and spinal neurostimulator implantation in hospital outpatient departments after which several professional physician societies, including the American Association of Orthopaedic Surgeons, North American Spine Society and International Society for the Advancement of Spine Surgery, wrote to CMS requesting a delay in implementation.

But in a June 3 letter, Connie Leonard, CMS director of provider compliance, said she would not delay the implementation of the prior authorization policy, explaining that it aims to prevent unnecessary care. CMS intends to send confirmation or denial of service within 10 days of receiving prior authorization requests and speed the process to two days for emergency cases, she said.

Spine surgeons have been critical of...(More)

For more info please read, CMS won't delay prior authorizations for outpatient cervical fusions, by Becker's ASC Review

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