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Response to Comments: Percutaneous minimally invasive fusion/stabilization of the sacroiliac joint for the treatment of back pain L36000
A54694
Wisconsin Physicians Service Insurance Corporation (J05)
Effective: December 17, 2015
Updated: December 31, 2025
Policy Summary
This document is a response to comments regarding a Draft LCD for percutaneous minimally invasive sacroiliac joint fusion/stabilization for back pain and does not itself define coverage criteria. No explicit indications, exclusions, documentation requirements, or frequency limits are provided here; review the final LCD or the referenced draft for the authoritative coverage rules.
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Key requirements from the full policy
"This article is a response to comments on a Draft LCD and does not specify coverage indications, limitations, documentation requirements, or frequency limits for percutaneous minimally invasive sac..."
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