Tricare approved coverage for minimally invasive SI joint fusion.
Tricare covers 9.4 million members of the U.S. military to receive care at 55 military hospitals and 373 military clinics. The new coverage guidance states "minimally invasive surgery (CPT procedure code 27279) for the treatment of sacroiliac joint pain is proven."
The coverage policy approval was set retroactively to Aug. 23, 2016 and covers surgery with technology such as the SI-BONE iFuse implant.
"Earlier this year, we met with Colonel Stephen C. Phillips, DO, and his staff at the Defense Health Agency in Washington, DC, and reviewed the extensive published clinical evidence for the iFuse implant," said Tony Recupero, chief commercial officer at SI-BONE. "Following that meeting, the Tricare policy team determined that coverage for MIS sacroiliac joint fusion was appropriate and warranted."
SI joint pain is often misattributed and is responsible for 15 percent to 30 percent of patients with chronic low back pain, as well as up to 43 percent of patients with new onset or persistent low back pain after lumbar fusion.