Sacroiliac Joint Injections and Procedures (L39462) - R1 - Effective March 19, 2023

Date Posted: February 5, 2026

This Local Coverage Determination (LCD) has been revised under contractor numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, and NMI), and 01312 (NV).

Effective Date: March 19, 2023

Summary of Changes:

SUMMARY OF EVIDENCE:

Added: A different procedure called cryoanalgesia, has been proposed for SIJ pain.

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Last Updated Feb 05 , 2026