Physician 2nd Quarter 2016 IRR – Interventional Pain Case Study #2

Coventry Healthcare (UT) Commercial - Use Aetna CPB 0016 as criteria.

Sacroiliac Joint Injection – 27096

64yoF with request for repeat bilateral sacroiliac joint injection after bilateral SI injection less than 5 weeks ago with 85% relief of pain. Tried and failed PT in 2015.

The physical examination prior to last visit showed tenderness at the sacroiliac joints and positive FABER maneuver.

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