For Patients
Minimally invasive spinal fusions offer an alternative to the standard open spinal procedures. Despite increasing physician and patient demand for minimally invasive spinal fusions, insurance coverage can sometimes be challenging. While over 10,000 AxiaLIF procedures have been performed in the US, not all health plans cover AxiaLIF.
TranS1 provides support for patients who have been denied insurance coverage for AxiaLIF. This patient advocacy has resulted in individual successes as well a number of broader positive coverage decisions.
As a patient, your first step in moving toward AxiaLIF insurance coverage is to talk to an AxiaLIF reimbursement specialist. The specialist will outline the process and timing of the appeals process. If you would like to move forward, you will be asked to complete a form that authorizes the specialist to speak with your surgeon and insurance company, as well as gather any relevant medical records.
For Surgeons
The AxiaLIF procedure (or Axial Lumbar Interbody Fusion) is a minimally invasive presacral approach to interbody fusion at the L4-S1 vertebral bodies, and is considered an alternative to other techniques. In January 2009, AxiaLIF was assigned a Category III CPT code (or “T-code”) by the American Medical Association (AMA).
A growing number of payors currently cover the T-Code, either via policy decisions or via individual case review. To lend our surgeon customers further support, TranS1 has established the AxiaLIF Reimbursement Support Line. The Support Line can provide you and your coding staff with assistance in resolving pre-authorization, resubmission and payment issues.
For Patients:
For Surgeons:
Call the AxiaLIF Reimbursement Support Line at 1-866-933-4249 now to speak with a representative.
This information is taken from the materials published by the Centers for Medicare and Medicaid Services and the American Medical Association. This information cannot guarantee coverage or reimbursement, and Trans1, Inc. makes no other representations as to selecting codes for procedures or compliance with any other billing protocols or prerequisites. As with all claims, individual physicians and hospitals are responsible for exercising their independent clinical judgment in selecting the codes that most accurately reflect the patient’s condition and procedures performed for a patient. Physicians and hospitals should refer to current, complete, and authoritative publications such as AMA CPT publications or insurer policies for selecting codes based on the care rendered to an individual patient, and may wish to contact individual carriers, fiscal intermediaries, or other third-party payors as needed.
