The medical record must be made available to Medicare upon request.
When the documentation does not meet the criteria for the service rendered, or the documentation does not establish the medical necessity for the services, such services will be denied as not reasonable and necessary under Section 1862(a)(1) of the Social Security Act.
Interlaminar and Caudal ESIs
Benyamin RM, Manchikanti L, Parr AT, Diwan SA, Singh V, Falco FJE, Datta S, Abdi S, Hirsch JA. The effectiveness of lumbar interlaminar epidural injections in managing chronic low back and lower extremity pain. Pain Physician. 2012; 15:E363-404.
Surgery Sparing Effect of ESIs
Riew K, Park J, Cho Y, et al. Nerve root blocks in the treatment of lumbar radicular pain. A minimum five-year follow-up. J Bone Joint Surg Am. 2006;88:1722-5.
Riew K, Yin Y, Gilula L, et al. The effect of nerve-root injections on the need for operative treatment of lumbar radicular pain. A prospective, randomized, controlled, double-blind study. J Bone Joint Surg Am. 2000;11:1589-93.
Therapeutic Transforaminal Injections
Ghahreman A, Bogduk N. Predictors of a favorable response to transforaminal injection of steroids in patients with lumbar radicular pain due to disc herniation. Pain Med. 2011;12:871–9.
Ghahreman A, Ferch R, Bogduk N. The efficacy of transforaminal injection of steroids for the treatment of lumbar radicular pain. Pain Med. 2010;11:1149–68.
MacVicar J, King W, Landers MH, Bogduk N. The Effectiveness of Lumbar Transforaminal Injection of Steroids: A Comprehensive Review with Systematic Analysis of the Published Data Pain Medicine. 2013 Jan; 14(1): 14–28.
Datta S, Manchikanti L, Falco FJE, Calodney AK, Atluri S, Benyamin RM, Buenaventura R, Cohen SP. Diagnostic Utility of Selective Nerve Root Blocks in the Diagnosis of Lumbosacral Radicular Pain: Systematic Review and Update of Current Evidence. Pain Physician 2013; 16:SE97-SE124.
Cohen SP, Bicket MC, Jamison D, Wilkinson I, Rathmell JP. Epidural Steroids A Comprehensive, Evidence-Based Review. Reg Anesth Pain Med. 2013;38:175-200.