MILD - good idea, needs some work. I've done 6, all > age 80, all reporting symptom improvement initially but only half are better at 6 months. I take significant issue with the thought that people doing MILD are somehow shady. My last MILD was 94, single level of stenosis, did well and is happy. She had a very thick ligament and a 5mm pseudolisthesis from facet widening. She would have fallen apart after a lami, but who in their right mind would PLIF her? As I saw/see it, it was MILD or nothing for her.
Agree with the idea of endoscopic spine, too bad 2012 CPT coding changes has essentially killed endoscopic spine surgery. An endoscopically-performed microdiscectomy, even if performed via interlaminar approach with hemilaminotomy, can only be billed as a 62287 (percutaneous discectomy) or perhaps 0275T, not a 63030.
Regarding coding for MILD, only 0275T is acceptable. Palmetto GBA, my CMS carrier in SC, is not paying a dime for it. I've done three since July, haven't seen a penny yet for any of them. Guess that makes me something other than greedy. Maybe stupid!