May 2021 LCDs Updates

FACET Joint Interventions for Pain Management (L35936)

In the Summary of Evidence section, the following corrections have been made:

Under the heading – Diagnostic Facet Joint Injections, a reference number has been added to the following:

• • Cohen et al in 2013, prospective study to evaluate predictive values and reported no difference in the predictive value of = 50% to <80% pain reduction vs. =80% pain reduction.

The following statement has been added under the heading - ASIPP (2020) Therapeutic Facet Joint Interventions Thoracic Spine:

• • Evidence to support use in the thoracic region is sparse. ASIPP reports level II evidence with moderate strength recommendation for thoracic spine, citing three diagnostic accuracy studies.

The following paragraph has been added under the bulleted text under the same heading - ASIPP (2020) Therapeutic Facet Joint Interventions Thoracic Spine:

• • Evidence to support use in thoracic region is further supported by one 2012 systematic review report evidence for diagnostic accuracy of the thoracic facet joint injection, and one 2018 study comparing thoracic IA vs. MBB reporting significant pain relief with thoracic joint injection. NASS guidelines cite the lack of supporting literature for the use of IA injections for thoracic pain, however, the guidelines also note the lack of other effective alternative therapies.

Posted 5/27/2021