SI joint pain affects millions of people in the US. This a diagnosis that has been acknowledged for the last couple of decades, however, is being recognized more than ever as new diagnostic techniques become available.
Currently health insurance companies are denying a surgical procedure, which has an 82% success rate after a 5 year period, stating that it is experimental and/or investigational. This is a life changing surgery. People with SI joint pain have a quality of life of 20% or less and this surgery drastically improves this, but the insurance companies are unwilling to approve the surgery.
As of January 1, 2015 the CPT code, 27279, for Minimally Invasive Surgical Sacroiliac Fusion was changed from a category 3 to a category 1, which is what is required for a surgical procedure to be considered non-experimental or investigational, however, even after the changing of the code, the insurance companies are still unwilling to approve it.
This petition will be sent to all major insurance companies as well as the state insurance commission in order to get this surgical procedure as the standard of care after all other methods of pain control have been met.
