Utah's Public Employees Health Plan issued a positive coverage policy for SI joint fusions using SI-Bone's iFuse Implant System.
Here are six things to know:
1. The policy specifies coverage for minimally invasive SI joint fusions using iFuse with prior authorization for current procedure terminology code 27279.
2. Utah's Public Employees Health Plan now considers open SI joint fusions, CPT code 27280, experimental and investigation.
3. Additionally, the policy considers SI joint percutaneous radiofrequency ablations and denervations experimental and investigational.
4. iFuse is a minimally invasive surgical implant system designed to fuse the sacroiliac joint to treat common disorders of the joint that can cause lower back pain.
5. iFuse Implant System has been used in over 28,000 procedures and included in 54 peer reviewed publications. The implant's six-year study was published in Neurosurgery.
6. Utah's Public Employees Health Plan provides coverage for more than 1 million residents in both the private and public sector.