These CMS changes would significantly improve spine care: 6 surgeons weigh in
By Admin | February 18, 2021
Question: What's one change CMS should implement that would greatly benefit spine care?
Michael Gordon, MD. Hoag Orthopedic Institute (Orange County, Calif.): If the benefit is for surgeons, I would say payment should be risk-adjusted and site of care should be irrelevant so surgeons are paid properly for risk and expertise and to avoid gaming the system on where to do surgery and how long to keep patients in the hospital.
1. [CMS] needs to pay more — spine surgeons have seen a steady decline in reimbursement.
2. Coding for outpatient anterior/posterior lumbar fusion is not up to date.
3. The bundled payment system is not good for spine. It needs modification.
If the benefit is for patients, I would create accessible, transparent, risk-adjusted outcomes data on each surgeon and facility so they can compare apples to apples when choosing.
Christian Zimmerman, MD. Saint Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): CPT modifier 22. As all are aware, this code is frequently indicated, but rarely honored by CMS reimbursements. The duplicative dictations and submissions of patient descriptors, complexity and additional time allotments are usually not enough to 'qualify' certain individuals for applied reimbursements. Especially in a patient populace that carries more acuity, risk and complication rates. Our anesthesia colleagues no longer submit...(More)
For more information please read, These CMS changes would significantly improve spine care: 6 surgeons weigh in, by Becker's SpineReview