The International Society for the Advancement of Spine Surgery released new coverage criteria for decompression with interlaminar stabilization.
The coverage recommendation policy examines decompression with interlaminar stabilization for lumbar spinal stenosis patients. The society doesn't recommend any one particular treatment but does recognize decompression with interlaminar stabilization as an option for treatment based on the patient's pathology, surgeon's expertise and shared decision-making process.
Among select patients, the rule notes decompression alone isn't adequate and those patients could benefit from interlaminar stabilization after direct decompression. Paradigm Spine's coflex has achieved FDA pre-market approval for patients who have up to Grade I spondylolisthesis.
There have been two prospective, randomized, multi-center, controlled, Level 1 clinical studies examining decompression with interlaminar stabilization. The studies provide "strong evidence" in support of interlaminar stabilization after decompression for quality of life and durability in the appropriate patients.
The new codes effective Jan. 1, 2017 include:
• CPT 22867 for "insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level"
• CPT 22868 for "insertion of interlaminar/interspinous process stabilization/distraction device without fusion, including image guidance when performed with open decompression, lumbar; second level (List separately in addition to code for primary procedure)"