Non-Coverage Decisions for SIJ RFN

Medicare Administrative Contractors (MACs) — CGS, Palmetto, WPS, NGS, and Noridian — released their final Sacroiliac Joint (SIJ) Injection and Procedures policies, effective 3/19/2023, misclassifying radiofrequency neurotomy (RFN) as not reasonable or necessary. Novitas and FirstCoast have not issued any new policies related to SIJ procedures.

IPSIS is carefully reviewing the new Local Coverage Determinations (LCD) and plans to reconvene the Multisociety Pain Workgroup to formulate a response expressing concerns with the determination and further promoting appropriate access to SIJ procedures for Medicare beneficiaries.

Additionally, an FAQ will soon be available to assist IPSIS members with navigating implementation of these new LCDs.

Click here to find your MAC.

IPSIS-led MPW collaborations provide a unified voice in advocating on behalf of all interventional pain physicians and the patients they treat. Help sustain this vital advocacy with your donations. The International Pain and Spine Intervention Society (IPSIS) is a tax-exempt organization under US section 501(c)(3) of the Internal Revenue Code. As such, contributions are deductible to the extent allowed by law.