New coding guidance: Prepare staff for the new SI joint LCD before March 19

Why This Topic Matters

The policy affects coverage and documentation for a common group of SI joint procedures across multiple jurisdictions, so billing and clinical staff need to understand the new LCD and companion guidance before it takes effect.

Article Sections

1. New SI joint LCD takes effect March 19

   Introduces the new Medicare local coverage policy for sacroiliac joint procedures and identifies the contractors involved. It also notes the companion billing and coding article and the jurisdictions affected.

2. Covered and non-covered procedures

   Summarizes the procedure categories addressed by the policy and notes that one service is not covered. This section focuses on the broad coverage scope described in the article.

3. Draft-to-final changes and reporting requirements

   Describes revisions made after public comment and the related reporting guidance referenced in the article. It also highlights the article’s emphasis on staff training using the final LCD and companion guidance.

4. Medical necessity and frequency limits

   Explains that the policy includes medical-necessity documentation themes and frequency-limit themes. It also discusses how the LCD organizes indications and the concept of a session for reporting purposes.