Spine, orthopedic organizations take position on image requirement in prior authorizations

Carly Behm -  

Nine spine and orthopedic societies argue that potential real-time image sharing requirements for prior authorizations may lead to unnecessary delays and denials of care.

Commercial health plans and other third-party payers have considered adding image sharing as a prior authorization requirement for spine surgery, according to a June 7 statement issued by the societies. The organizations say that requirement is concerning because of additional costs, erroneous conclusions and the potential to devalue the importance of patient history and examination.

"The doctor-patient relationship is an indispensable component of shared decision-making in choosing to undergo spine surgery," the statement said. "This choice must remain the purview of the patient and the surgeon. Using imaging studies in isolation, without clinical context, may undermine appropriate clinical diagnosis and treatment plans. The concept that image sharing should be a basis for prior authorization is an unnecessary and unwelcome impingement on the doctor-patient relationship, which will detrimentally interfere with the decision for spine surgery. Physicians who treat spine conditions adamantly oppose requiring the submission of patient images as a prior authorization requirement for spine surgery."

The organizations endorsing the statement are:

American Academy of Orthopaedic Surgeons/American Association of Orthopaedic Surgeons

American Association of Neurological Surgeons

Cervical Spine Research Society

Congress of Neurological Surgeons

AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves

International Society for the Advancement of Spine Surgery

Lumbar Spine Research Society

North American Spine Society

Scoliosis Research Society

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