Subject: NASS Draft Coverage Policy for Lumbar Artificial Disc Replacement
Dear Dr. Resnick,
The American Association of Neurological Surgeons (AANS), Congress of Neurological Surgeons (CNS)
and the AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves (DSPN) appreciate
the opportunity to provide comments on the North American Spine Society (NASS) coverage policy
recommendations for Lumbar Artificial Disc Replacement. Below are our recommendations.
NASS Coverage Recommendations
- Lumbar Artificial Disc Replacement is indicated for patients with discogenic low back pain who meet
ALL of the following criteria from the Lumbar Fusion Coverage Recommendation:
Advanced single level disease noted on an MRI and plain radiographs of the lumbar spine at L4-5 or
L5-S1, characterized by moderate to severe degeneration of the disc with Modic changes (defined as
peridiscal bone signal above and below the disc space in question) as compared to other normal or
mildly degenerative level (characterized by normal plain radiographic appearance and no or mild
degeneration on MRI).
…
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