The new policy would not provide access to lumbar fusion for patients when the sole indication is disc herniation or degenerative disc disease. The policy states, "Due to lack of evidence of improved outcomes, spinal fusion is considered not medically necessary when the sole indication is disc herniation, DDD, facet syndrome or initial discectomy and/or laminectomy for neural structure decompression."
The International Society for the Advancement of Spine Surgery is currently conducting a review of the policy and will issue comments to HCSC before its deadline of May 31.
ISASS encourages surgeons to respond to the policy as well.
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Spinal Fusions Under Attack: BCBS of Illinois, New Mexico, Oklahoma & Texas Issues New Draft Policy FeaturedWritten by Laura Miller | May 22, 2012
The Health Care Service Corporation, the parent corporation for the Blue Cross/Blue Shield plans for Illinois, New Mexico, Oklahoma and Texas issued a new draft policy for lumbar spinal fusions.
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