Washington E-Newsletter

Neurosurgery Continues to Urge Aetna to Modify ACDF Surgical Policy

Despite two decades of scientific literature, Aetna remains the only major commercial insurer that routinely denies coverage for interbody spacers in anterior cervical discectomy and fusion (ACDF). Aetna’s policy deems poly-ether-ether-ketone, or PEEK, and metallic spacers (CPT code 22853) as “experimental and not medically necessary” for routine ACDFs. Neurosurgery has vigorously opposed this position for many years. Most recently, on April 25, the AANS, CNS and AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves joined other spine societies in sending a letter to Aetna urging the health plan to update its coverage to empower the surgeon and the patient to decide which implants to use in their spine surgery. In addition, the societies contacted the Centers for Medicare & Medicaid Services, asking the agency to review this matter with Aetna-sponsored Medicare Advantage plans.