February 10, 2023

CMS Releases Local Coverage Policy Regarding Sacroiliac Joint Injections and Procedures

The Centers for Medicare and Medicaid Services (CMS) pain management workgroup, with representation from all Medicare Administrative Contractors (MACs), released a final local coverage determination (LCD) for sacroiliac joint injections and procedures. The LCD, which goes into effect in March, was developed and adopted by five out of seven MACs and has a 45-day notice period; MACs are independent and based on assigned regions.

Future Local Coverage Determination (LCD): Sacroiliac Joint Injections and Procedures

Medicare Administrative Contractor  Future LCD Response to Comments article Future Coding & Billing article
CGS Administrators, LLC L39383 A59301 A59154
National Government Services Inc.  L39455 A59319 A59233
Noridian Healthcare Solutions, LLC  J-E L39462
J-F L39464
J-E A59333
J-F A59334
J-E A59244
J-F A59246
Palmetto GBA  L39402 A59309 A59192
Wisconsin Physicians Service Insurance Corporation  L39475 A59329 A59257


The American College of Radiology® (ACR®) is educating members about the new policy and associated billing and coding article for this clinical topic. Members should review the policy and associated billing and coding articles in the chart to avoid unnecessary denials of services or delays in reimbursement.

In addition to ACR resources, CGS Administrators, one of the seven MACs, will host an educational webinar Friday, Feb. 17, 12-1 pm ET. During the webinar, they will identify Medicare's coverage limitations for sacroiliac joint injections and address pre-submitted questions. Submit questions to be addressed during the webinar to J15MRPOLICY@cgsadmin.com.

The meeting is open to the public, physicians, billing staff and ACR representatives. Registration is available online.

If you have questions or would like more information about local coverage policies and activities, contact Alicia Blakey, ACR Principal Economic Policy Analyst.