May 21, 2024

ACR and Partner Societies Challenge Aetna Position on Vertebral Augmentation

The American College of Radiology® (ACR®) joined other medical specialty societies whose members utilize and/or perform interventional spine procedures in a letter to Aetna leadership regarding the insurance giant’s failure to revise its policy on vertebral augmentation procedures. Aetna’s policy limits surgical procedures to fractures more than six weeks old; however, the medical societies contend these requirements should be revised/eliminated as they can potentially negatively impact patient outcomes and providers' ability to deliver evidence-based, appropriate spinal care to all patients.

ACR and the other specialty societies previously submitted letters to six commercial insurance payers asking them to change the medical necessity language contained in their coverage policies for Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture. Commercial payers were urged to align their plans with Medicare coverage policies that have been effective since 2021.

For more information or if you have questions, contact Alicia Blakey, ACR Principal Economic Policy Analyst.