Medical Necessity Determination for Sacrococcygeal Disorders

Evidence-Based Treatment Algorithm

• The British Medical Journal provides a strong recommendation against interventional procedures for chronic axial spine pain, including epidural injections, joint radiofrequency ablation, joint-targeted injections, and intramuscular injections, representing the highest quality and most recent guideline evidence available 1
• Optimization of medication management is recommended as part of conservative therapy for coccydynia, according to the British Medical Journal guideline 1

Specific Criteria NOT Met

• The British Medical Journal guideline provides a strong recommendation against interventional procedures for chronic axial spine pain, which has not been met in this case due to inadequate conservative management and lack of diagnostic confirmation 1
• Diagnostic confirmation through dynamic radiographs and diagnostic injection is necessary before considering interventional procedures, as recommended by the British Medical Journal guideline, but has not been completed in this case 1