If a patient fails an initial diagnostic or therapeutic injection is there a certain criteria that must be fulfilled prior to considering it again, such as duration since the last injection (like over a year ago) or change in symptom character or location?
Yes, the LCD states: The diagnostic SIJI provided a minimum of 75% relief of primary (index) pain with the diagnostic SIJI (a positive diagnostic response is defined as ≥75% sustained and constant pain relief for the duration of the local anesthetic and ≥75% sustained and constant pain relief for the duration of the anti-inflammatory steroid) was measured by the same pain scale* at baseline. If the injection fails to meet that criteria it would not be expected to be repeated. If there is rationale for repeated injection such as a long duration between initial evaluation or changes in symptoms/ location the rationale must be documented in the medical record.