Transcription of Sacroiliac Joint Interventions
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Sacroiliac Joint Interventions
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 .. 3. Description of Services .. 3 Community Plan Policy Clinical Evidence .. 4 Sacroiliac Joint Interventions Food and Drug Administration .. 8. References .. 8. Policy History/Revision Information .. 9. Instructions for Use .. 10. Coverage Rationale Note: This policy addresses intraarticular Sacroiliac Joint injections and Fusion. This policy does not address radiofrequency ablation of the Sacroiliac Joint . For coverage criteria regarding radiofrequency ablation of the Sacroiliac Joint , refer to the policy titled Ablative Treatment for Spinal Pain.
Axial Skeleton: In the human body, the bones of the body axis, including the skull, vertebral column, ribs, and sternum. Titanium Triangular Implant: A ®Sacroiliac Joint (SIJ) implant (e.g., iFuse Implant System ) intended for treating low-back pain ... guidance (i.e., fluoroscopy or computed tomography) CPT ...
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