Why has Priority Health established Spine COE?
• 90% of acute low-back pain resolves with conservative care, including physical medicine management. • Physiatrist-led clinics have been shown to significantly reduce the need for surgery. What does this mean to East Region providers? Effective May 1, 2009,* all referrals for back and neck pain to orthopedic surgeons and neurosurgeons need prior authorization. Patients who have suspected trauma, infection, tumor, or evidence of bowel or bladder incontinence or retention or myelopathy will be approved for surgical evaluation. Patients who require emergency department follow-up also will be approved. All other patients will be required to be evaluated in a Spine COE. This won’t affect services by other specialists, such as pain specialists, or referrals for non-spine-related orthopedic or neurosurgical problems. We’ve sent information to PCPs regarding this program. Information also is available online through the Provider Center. * This effective date applies to the East Region. All ot
