News & Press: Advocacy

BCBSRI’s SI Joint Pain Policy Inappropriately Classifies LBRFN as Investigational

Thursday, May 9, 2019  
The draft Diagnosis and Treatment of Sacroiliac Joint Pain coverage policy of Blue Cross Blue Shield of Rhode Island excludes coverage for lateral branch radiofrequency neurotomy, classifying it as investigational.

On May 7, 2019, the Spine Intervention Society (SIS) submitted a comment letter to the insurer recommending that the procedure is an appropriate treatment for suitably selected patients, based on the SIS-convened multispecialty collaborative-endorsed set of appropriate use criteria for sacroiliac interventions.

Acknowledging the strength and quality of the evidence in support of the safety and effectiveness of LBRFN, the American Medical Association’s Current Procedural Terminology (CPT®) Editorial Panel has approved a Category I code that is expected to go into effect on January 1, 2020.

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