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Notification of Guideline Revisions Effective March 1, 2023 (Posted December 13, 2022)

Guideline notifications given 12/13/22 for effective date 3/1/23. These updated guidelines will be viewable 3/1/23 by logging in to the MCG Cite Guideline Transparency (CGT) Portal, however, the revisions to the guidelines are noted below.

  • Cervical Diskectomy or Microdiskectomy, Foraminotomy, Laminotomy ISC: S-310
  • Cervical Fusion, Anterior ISC: S-320
  • Cervical Fusion, Posterior ISC: S-330
  • Lumbar Diskectomy, Foraminotomy, or Laminotomy ISC: S-810
  • Lumbar Laminectomy ISC: S-830
Care GuidelineRevision
Cervical Diskectomy or Microdiskectomy, Foraminotomy, Laminotomy Guideline title updated to Cervical Diskectomy or Microdiskectomy, Foraminotomy, Laminotomy ISC ORG S-310-NC. Update to Clinical Indications for Procedure section requiring 6 weeks of physical therapy in addition to another nonoperative therapy for cervical radiculopathy (in the absence of progressive (i.e., worsening) neurologic deficits (e.g., weakness)). Reference added.  Guideline Customization Update section added. Medical Director review.  Notification given 12/13/22 for policy effective date 3/1/23.
Cervical Fusion, Anterior Guideline title updated to Cervical Fusion, Anterior ISC ORG S-320-NC. Update to Clinical Indications for Procedure section requiring 6 weeks of physical therapy in addition to another nonoperative therapy for cervical radiculopathy (in the absence of progressive (i.e., worsening) neurologic deficits (e.g., weakness)). Reference added.  Guideline Customization Update section added.  Medical Director review.  Notification given 12/13/22 for effective date 3/1/23.
Cervical Fusion, Posterior Guideline title updated to Cervical Fusion, Posterior ISC ORG S-330-NC. Update to Clinical Indications for Procedure section clarified that 6 weeks of physical therapy is required as part of the nonoperative therapy for cervical pseudoarthrosis. Reference added.  Guideline Customization Update section added.  Medical Director review.  Notification given 12/13/22 for effective date 3/1/23.
Lumbar Diskectomy, Foraminotomy, or Laminotomy 

Guideline title updated to Lumbar Diskectomy, Foraminotomy, or Laminotomy ISC ORG S-810-NC. Update to Clinical Indications for Procedure section requiring physical therapy in addition to other nonoperative therapy for lumbar radiculopathy and clarified that 6 weeks of physical therapy is required as part of the nonoperative therapy for lumbar spondylolisthesis (in the absence of rapidly progressive or very severe neurologic deficits). Reference added.  Guideline Customization Update section added.  Medical Director review.  Notification given 12/13/22 for effective date 3/1/23.

Lumbar Laminectomy 

Guideline title updated to Lumbar Laminectomy ISC ORG S-830-NC. Update to Clinical Indications for Procedure section clarified that 6 weeks of physical therapy is required as part of the nonoperative therapy for lumbar spinal stenosis (in the absence of rapidly progressive or very severe symptoms of neurogenic claudication confirmed with imaging) and for lumbar spondylolisthesis (in the absence of rapidly progressive or severe neurologic deficits). This section also updated to require 6 weeks of physical therapy in addition to another nonoperative therapy for lumbar disk disease.  Reference added.  Guideline Customization Update section added.  Medical Director review.  Notification given 12/13/22 for effective date 3/1/23.