California workers’ spinal surgery compensation declines


A California Workers’ Compensation Institute (CWCI) study has found a 21% reduction in the number of workers’ compensation implant-eligible spinal surgeries between 2012 and 2014.

The study quantified and compared the use of inpatient services and procedures for different systems using data compiled by the state on more than 24 million hospitalisations from 2008 through 2014.

According to a press release, this reduction in spinal surgery-related compensation has coincided with continued development of evidence-based medicine, utilisation review, and independent medical review, fee schedule changes, and the phase out and ultimate repeal of duplicate “pass-through” payments for hardware used in workers’ compensation spinal surgeries.

The study identified the 10 most common inpatient diagnosis-related group codes (MS-DRGs) in workers’ compensation for 2013 and 2014; calculated the average charged and paid amounts for the top 10 workers’ compensation MS-DRGs; and measured changes in the volume of implant-eligible spinal surgeries and in the proportion of spinal fusion MS-DRG discharges to total discharges across time for each payer group.