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Sacroiliac Joint Interventions

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UnitedHealthcare Commercial Medical Policy Sacroiliac Joint Interventions Policy Number: 2021T0621B. Effective Date: November 1, 2021 Instructions for Use Table of Contents Page Related Commercial Policies Coverage Rationale ........................................ ............................... 1 Ablative Treatment for Spinal Pain Documentation Requirements ........................................ .............. 2 epidural steroid Injections for Spinal Pain Definitions ........................................ ........................................ ...... 2. Facet Joint Injections for Spinal Pain Applicable Codes.

• Epidural Steroid Injections for Spinal Pain ... Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography . Description of Services . Sacroiliac (SI) Joint Fusion is a surgical procedure, which fuses the iliac bone (pelvis) to the spine (sacrum) for stabilization. ...

  Injection, Steroid, Epidural, Epidural steroid injections

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