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ISIS Strongly Objects to CMS’ Decision to Decrease Values of Interlaminar Epidural Injections

Posted By Administration, Wednesday, December 18, 2013

On November 27, 2013, the Centers for Medicare and Medicaid Services (CMS) released the final rule of the Medicare Physician Fee Schedule. In it, CMS announced that it will not accept the proposed physician work relative value units (RVUs) for interlaminar epidural injections.

These injections underwent an extensive review by the RUC after code 62311 was "flagged” by CMS as a potentially misvalued code on their high expenditure screen, published in 2011. As such, the entire family of codes had to be reviewed. In 2012, ISIS, along with multiple other medical societies, surveyed their membership on the time and work intensity involved in the performance of these procedures. After the survey, the results and value recommendations were presented to the AMA Relative Value Update Committee (RUC). The RUC accepted the specialty societies’ recommendations to keep the physician work values at the same level (except for 62310, which was lowered from 1.91 to 1.68).

We are disappointed to learn that CMS did not accept the values that were approved by a national expert panel consisting of representatives from 26 different medical societies. Additionally, major decreases were published by CMS on the Practice Expense components of these codes. ISIS is currently reviewing these to assess our options. Click here to read more.

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