Becker's Spine Review

6 SPINE Prior authorization reform 'long overdue,' says 1 spine surgeon By Claire Wallace P rior authorization can be a long process for physicians and patients, resulting in time delays, increased paperwork and disrupted patient care. According to a March 14 report from the AMA, physicians and their staff spend up to two whole workdays per week filling out prior authorization paperwork, with some practices forced to hire additional staff just to handle prior authorization claims. Additionally, according to data from the Kaiser Family Foundation, Medicare Advantage insurers deny, or partially deny, over 2 million claims a year. Domagoj Coric, MD, spine and neurosurgeon at SpineFirst at Carolina Neurosurgery and Spine Associates in Charlotte, N.C., and an endowed professor of spine surgery at Atrium Health in Charlotte, believes that reform is long overdue. Dr. Domagoj Coric: A long overdue payer change is prior authorization reform. e prior authorization process is an onerous and opaque process, mandated by payers, which consumes significant healthcare resources. is wasteful process is exacerbated by the fact that prior authorization approval does not guarantee payment. e entire pre-approved surgical procedure is routinely denied payment if any additional procedure is performed. is is an unconscionable situation. At a minimum, obtaining prior authorization should equate to insurance coverage and payment of the pre-approved codes. Any additional procedures can subsequently be adjudicated based on medical necessity. Hopefully, 2023 will bring substantial prior authorization changes. n Dr. Michael Gallizzi completes his 200th robotic spine surgery By Carly Behm Spine surgeon Michael Gallizzi, MD, completed his 200th robotic case on April 4, according to e Steadman Clinic. More than 100 of those cases were performed since Dr. Gallizzi joined the Vail, Colo.-based practice, according to an April 6 news release. His 100th robotic spine case was completed just under a year ago on April 19, 2022. Dr. Gallizzi said in the release that preoperative planning features have been a key component in spine robot growth. "Being able to preoperatively plan all the different aspects of the sur- gery, line up the screws or implant them exactly where they need to be is an advantage when you use the robotic tool. So it all becomes a homologous construct for the patient," he said. "Without robotics, this would be extremely difficult even in the best hands, but with ro- botics it has become something that is more reliable and reproducible to allow patients that have had previous surgeries to have improved outcomes." Dr. Gallizzi's milestone comes shortly aer he announced he became the first spine surgeon in the Colorado Rockies region to incorporate three major endoscopic spine techniques in his practice. n Geisinger Medical Center performs 1st lumbar spinal fusion with 'lifetime guarantee' By Claire Wallace E dward DelSole, MD, has performed the first lumbar spinal fusion surgery with a lifetime guarantee at Danville, Pa.-based Geisinger Community Medical Center. The lifetime guarantee for the procedure was launched by Geisinger Health Plan and devicemaker Medacta Group. Dr. DelSole performed the procedure using Medacta's M.U.S.T Pedicle Screw System and MIS MySpine MCpatient matched solution. "This new guarantee allows us to expand our ProvenCare commitment for patients who qualify for spinal fusion surgery while offering them a sense of security on the clinical outcome when making the decision to have the procedure," Michael Suk, MD, chair of the department of orthopedic surgery at Geisinger, said in a March 8 press release. "By standing behind our world-class joint replace- ment, spinal surgeries and other orthopedic care options, Geisinger is demonstrating its commitment to making bet- ter health easier and more accessible for our patients and communities." n

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