Issue link: https://beckershealthcare.uberflip.com/i/704577
44 Novel Technologies Make a Splash in Outpatient Spine Setting — Dr. Nick Shamie Weighs In By Megan Wood W hen considering adding spine to an ASC, Nick Shamie, MD, of Santa Monica-based UCLA Spine Center, recommends surgeons check coverage for specific procedures. Payers may not cover certain procedures a surgeon wishes to perform, in which case the cash prices must be affordable for patients. "I think the one issue with these novel technologies is coverage, because some insurance companies won't cover," says Dr. Shamie. He recommends a few novel procedures that fit well within the outpatient setting. "ere are some novel techniques that I think are going to be helpful because of vey little risk of injury to structures," says Dr. Shamie. For cervical stenosis procedures, Dr. Shamie places a spacer between facet joints to elevate the bones and free up the nerve. "You don't have to make any incision that you have to look through, because it's done percutaneously," he says. Dr. Shamie utilizes the following two technologies in the outpatient setting: VertiFlex's Superion Interspinous Spacer, which is an indirect decom- pression spinal implant system for lumbar spinal stenosis treatment. Dr. Shamie places the spacer between the bones to jack up the height. Surgeons have implanted more than 2,000 of these devices in patients around the globe. Paradigm Spine's coflex, which is the first motion preserving minimally invasive treatment for spinal stenosis post decompression. Dr. Shamie places the coflex between the lamina to help maintain the foramina. Of the 650,000 to 700,000 spine cases performed in the U.S. annually, about 280,000 to 300,000 are done on an outpatient basis. Lumbar decompression and anterior cervical fusions, for example, are most commonly performed in the outpatient setting. In 2015, CMS added nine new spine procedure codes on the ASC payable list: • Neck spine fusion & removable c2 (22551) • Neck spine fusion (22554) • Lumbar spine fusion (22612) • Neck spine disc surgery (63020) • Low back disc surgery (63030) • Laminectomy single lumbar (63042) • Removal of spinal lamina (63045) • Removal of spinal lamina (63047) • Decompression spinal cord (63056) "e smaller the surgery, the more appropriate it is in an ASC," says Dr. Shamie. "e bigger the surgery, the riskier it gets." All ASCs are required to have transfer agreements with a hospital. "Planning is very important," Dr. Shamie says. "A quote from Coach John Wooden comes to mind: 'failing to prepare, is preparing to fail.'" Although these novel techniques will continue to gain traction in the outpatient spine environment, Dr. Shamie does not believe they will replace the traditional techniques. "ose old techniques are tried and true and some of these novel techniques have limitations based on who are appropriate patients," says Dr. Shamie. n Rothman Institute, Humana Sign In-Network Contract Including Medicare Advantage: 5 Key Notes By Laura Dyrda R othman Institute in Philadelphia signed an in-network contract with Humana. Here are five key notes on the agreement: 1. The new network includes Humana's Medicare Advan- tage plans in Southeastern Pennsylvania, which now has 8,80 members in the region and 41,000 across Pennsylva- nia. 2. Humana's members will now have in-network access to Rothman Institute providers, which includes 130 physicians with 23 offices in Southern Pennsylvania and New Jersey. 3. Humana members will be able to see Rothman physi- cians in their practices as well as access the orthopedic urgent care facility in Limerick, Pa., where they can see a specialist without an appointment. 4. Rothman Institute has subspecialists in sports medi- cine, hip and knee, foot and ankle, shoulder and elbow, hand and wrist and spine care. The practice also includes orthopedic oncology, trauma and physical medicine and rehabilitation. 5. Alexander Vaccaro, MD, leads Rothman Institute which includes team physicians for the Philadelphia Phillies, Phila- delphia Flyers, 76ers and Eagles. "A core principle of our practice is providing seniors with the highest quality of care, an affordable price, at a location close to their home," said Mick West, Rothman Institute CEO. "This partnership is a win-win for both Humana's members and Rothman Institute, and we both anticipate a successful relationship." n