The policy allows diagnostic and therapeutic injections if criteria is met for the Sacroiliac joint which is defined within the policy as: Sacroiliac Joint Complex- the articular portion of the joint, including bone, articular cartilage and joint capsule and the posterior extraocular structures which include the overlying dorsal ligaments, regional muscles and tendons.

However, injection of the posterior ligaments, rather than the dorsal ligaments that are considered part of the SIJ complex, might complicate the assessment of the response to intervention and should not be separately performed.