In the letter, Dr. LeHuec expresses concern with the lack of coverage for patients with spinal stenosis when compression leads to iatrogenic instability and the refusal to cover multi-level fusions for patients with spondylolisthesis. The Draft LCD also limits the coverage for patients with DDD, which ISASS finds medically necessary for a maximum of two levels.
The Draft LCD also states that it was developed in cooperation with orthopedists and neurosurgeons from various societies, but the letter maintains organizations such as ISASS, American Association of Neurological Surgeons/Congress of Neurosurgeons, North American Spine Society and the American Academy of Orthopaedic Surgeons were not consulted.
Read the letter from Dr. Jean-Charles LeHuec (pdf).
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