The move to add prior authorization for some spine procedures under CMS’ new Wasteful and Inappropriate Service Reduction model concerns some physicians. However Christian Zimmerman, MD, said some of these additions were a long time coming.
Dr. Zimmerman, of St. Alphonsus Medical Group and SAHS Neuroscience Institute in Boise, Idaho, said some procedures should be examined as closely as surgery.
“Prior authorizations are overdue for many of these mechanically inadequate (relieving), and near placebo rendering procedures promulgated by many non-surgeons/pain administrators,” he told Becker’s. “The presentations of objective data sets coupled with demonstrable radiologic adjunct should be equally scrutinous as the pursuance of complex spinal surgery. The approval process should parallel one’s own correlative data, outcomes and complications, clinical experience and appropriate correlates of disease and surgical application. Too many patients present to the surgical forum after having three and four series of epidural injections with the same dissatisfying, repetitive result.”
