Coverage Recommendations

New direction by NASS in proactively developing evidenced-based coverage recommendations for common spine care treatments, procedures and diagnostics.​​ Now available in a comprehensive, searchable and user-friendly eBook format!

Overview

As part of its mission to foster the highest quality, evidence-based and ethical spine care, the NASS Board of Directors approved the formation of multi-specialty team to focus on defining appropriate coverage positions to assist payors, physicians and their patients on fair coverage for spine care. NASS is developing credible and reasonable coverage recommendations based on extensive literature research while incorporating existing NASS health policy comments and evidence-based guidelines.

NASS coverage recommendations are developed to advocate for NASS’ positions on various clinical and practice issues to ensure continued provision of quality spine care. NASS will continue its efforts to advocate for fair and appropriate coverage decisions while promoting evidence-based medicine.

Coverage Recommendations Methodology

Thank You for Your Comments! 

The NASS Coverage Committee extends its sincere appreciation for the feedback we have received on our proposed DNA-Based Scoliosis Test coverage recommendations. The public comment period is now closed, and the comments are currently being reviewed and considered by the NASS Coverage Committee. Where appropriate, the Committee will make edits and then publish the final coverage recommendations in the Coverage eBook.

NASS Coverage Recommendations eBook

NASS is pleased to offer these game-changing coverage recommendations now in a comprehensive, searchable e-book for free to all NASS members and for an annual subscription to non-members. Spine specialists can use this up-to-the-minute material to provide evidence to support their treatment recommendations and seek appropriate reimbursement for quality spine care.



Current Coverage Policy Recommendations

 

  • Cervical artificial disc replacement (revised)
  • Endoscopic discectomy
  • Cervical epidural injections
  • Cervical fusion
  • Cervical laminoplasty
  • Interspinous device without fusion
  • Interspinous fixation with fusion
  • Lumbar artificial disc replacement
  • Lumbar discectomy
  • Lumbar fusion
  • Lumbar laminectomy
  • Lumbar laminotomy
  • Lumbar spinal injections
  • Laser spine surgery
  • Percutaneous sacroiliac joint fusion
  • Percutaneous thoracolumbar stabilization
  • Recombinant human bone morphogenetic protein (rhBMP-2)
  • Sacroiliac joint injections

Anticipated Coverage Policy Recommendations

 

  • Advanced imaging
  • Allograft derivatives
  • Cell-based bone grafts
  • Cervical laminectomy
  • Discography
  • DNA-based scoliosis test
  • Intraoperative neurophysiologic monitoring
  • Kyphoplasty, vertebroplasty, sacroplasty
  • Pain pumps
  • Percutaneous discectomy and other percutaneous decompression procedures
  • Percutaneous lumbar fusion
  • Physical therapy
  • Sacroiliac radiofrequency ablation
  • Spinal cord stimulation
  • Synthetics
  • Spine radiosurgery
  • TENS and other electrical stimulation for back pain
  • Thoracic and thoracolumbar fusion

Disclaimers

NASS Coverage Recommendations Disclaimers:

  • The North American Spine Society Coverage Recommendations are developed to assist payers, providers and patients in determining whether medical services and procedures should be covered for payment based on review of the best available clinical evidence and the expert opinion of committee members.​ 
  • NASS coverage recommendations are reviewed and updated periodically and are therefore subject to change.
  • These materials may not be modified in any way without the express permission of NASS. If materials are reproduced, transmitted, distributed or duplicated in anyway, the materials must be reproduced, transmitted, distributed or duplicated in their entirety.

Translation Disclaimer:

  • Coverage recommendations may be reprinted and translated with the permission of NASS. NASS does not verify, certify and is not responsible for the accuracy of any translations, and has advised any parties translating the NASS coverage recommendations to carefully verify the accuracy of their translations prior to publication and dissemination.
  • In addition, NASS asks that any prospective translator complete the coverage recommendations translation record​ and send a copy to NASS to keep on file so that NASS may track all translations, appropriately direct individuals to translations of interest and notify translators of content updates and revisions.

Comments

Comments regarding the coverage recommendations may be submitted to the North American Spine Society and will be considered in development of future revisions of the work.