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Neurosurgery Presses Aetna to Modify ACDF Surgery 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 ACDF. On Aug. 30, the AANS, CNS and AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves sent 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.

Aetna clinical policy staff has agreed to meet with representatives from neurosurgery to discuss this issue.

September E-News