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.
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