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Upcoming changes to medical policies on spinal injections

October 1, 2014

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Effective January 1, 2015, Medical Policy #11.15.23 will be updated to version "c" and retitled as Epidural, Paravertebral Facet, and Sacroiliac Joint Injections for Spinal Pain Management. The updated policy will be expanded in scope to include policy statements that address multiple spinal injection techniques that are routinely used in the diagnosis and treatment of spinal pain, such as:

  • paravertebral facet joint injection
  • transforaminal epidural
  • caudal epidural
In addition to an expansion in scope, the revised Epidural, Paravertebral Facet, and Sacroiliac Joint Injections for Spinal Pain Management policy will include policy statements that address a number of varying injection techniques and the frequency of therapy considered to be medically necessary and eligible for reimbursement consideration. The updated policy also addresses anesthesia in conjunction with these services.

Stay up to date on policy activity by visiting our Medical Policy Portal and selecting Accept and Go to Medical Policy Online. You can also view policy activity using the NaviNet® web portal by selecting Reference Tools from the Plan Transactions menu, then Medical Policy.

Note: These medical policy updates apply to commercial business only. Please see the separate Medicare Advantage policy portfolio for the corresponding policies.

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