CPT G0260 · SI Joint · BCBS Oklahoma
SI Joint Injection (Medicare ASC HCPCS) at BCBS Oklahoma.
How BCBS Oklahoma approaches CPT G0260 (SI Joint Injection (Medicare ASC HCPCS)) for prior-authorization review: at last review on 2024-10-28, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2024-10-28
Policy number
MSK01-0725.1v2Criteria summary
High-level themes from the BCBS Oklahoma policy of record for CPT G0260. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 6 weeks of conservative care typically required.
- Imaging concordance documentation required.
See the full BCBS Oklahoma criteria.
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