CommercialCoverageHigh impact
Epidural Steroid Injections
Blue Cross & Blue Shield of Mississippi·MS · Pain Management, Anesthesiology, Neurosurgery +2 more·Medical Policy
We identified it
Jun 20, 2026
Summary
This policy establishes coverage guidelines for epidural steroid injections, limiting reimbursement to 3 injections per calendar year at any one level. Key requirements include documented radicular pain, no separate billing for injected drugs, and mandatory fluoroscopic guidance for third injection if first two non-fluoroscopic injections fail.
Action Required
Immediately: Billing team must configure system to limit epidural steroid injection claims to maximum 3 per calendar year per spinal level. Update billing rules to bundle drug costs with injection administration - do not bill separately for injected medications. Providers must document radicular pain diagnosis and track injection count per level. For third injections, verify fluoroscopic guidance was used if first two were non-fluoroscopic and failed. Claims exceeding annual limits or lacking proper documentation will be denied.