Contributing author, Clinical Health Psychologist William W. Deardorff, PhD, ABPP stresses the importance of pre-surgical psychological screening for patients considering an elective spine surgery.
You can see his first 2 parts in this blog series here:
This week, Dr. Deardorff describes what to expect after having a pre-surgical psychological screening.
What should a patient expect after undergoing a pre-surgical psychological screening?
The pre-psychological screening will likely yield 1 of 3 results:
- All clear for surgery
- Recommend further preparation for surgery treatment
- Avoid the surgery due to high risk for clinical failure
If your psychologist recommends surgery preparation, he or she will focus the treatment plan to address concerns that were identified during the pre-psychological screening.
- Treating identified depression
- Detoxing off of too much medication
- Undergoing a pre-operative muscle strengthening program
- Cognitive therapy for coping with chronic pain
- Psycho-educational approaches to manage expectations about the spine surgery outcomes
If a patient is found to be a poor surgery candidate and it is not recommended, other treatment options might include a pain program similar to the one I mentioned previously (in The Psychology of Pain Blog Series 1).
Does insurance generally cover these screenings?
That is very difficult to say given the overwhelming number of policies. Often, a patient will get a referral for the pre-surgical screening from the surgeon, and this can be considered as being medically necessary. In these cases, the pre-surgical screening may be covered under medical benefits (versus mental health).
In any case, the most prudent approach is to discuss the coverage with one’s insurance company ahead of time. Generally, the patient can obtain the CPT codes (the charge codes) from the psychologist doing the pre-surgical screening and ask the carrier about coverage. The pre-surgical screening will generally consist of an interview with the psychologist and psychological testing.
Most spine surgeons who value pre-surgical screenings will have a psychologist they refer to often. Otherwise, you might try and find a psychologist who is a member of the North American Spine Society (NASS), American Pain Society (APS) or similar multidisciplinary professional organization. Larger spine surgery practices, especially those associated with university medical schools will have a spine psychologist as part of the treatment team.