In all likelihood, if the surgeon is dictating that they had performed an XLIF, which would be appropriate, and the payors are scrutinizing the operative notes, don't the codes need to match the procedure? So in the spirit of debate is it an ALIF, or, is it an XLIF? Herein lies the problem! If the surgeon dictates that an ALIF was performed, when in fact an XLIF was performed, would that constitute fraud?
Another point of clarification is that the amount a surgeon is reimbursed for a true ALIF is different than what a surgeon is reimbursed for an XLIF. In an ALIF, there is usually an Access Surgeon whether it be a General or Vascular Surgeon. In all likelihood the primary attending is splitting some percentage of the reimbursement with the access surgeon. Isn't that how NuVasive originally marketed this product? That you would no longer need an Access Surgeon and that the procedure was safer? TSB has the utmost respect for anyone as successful as NuVasive, yet, one has to wonder whether or not some of this commentary was factually correct?
Confusion? Maybe? Could be where the problem lies with the payors. TSB wants to know what our readers think?