Diagnostic imaging for acute Low Back Pain (LBP)

December 11, 2020

Effective October 30, 2020, TRICARE no longer provides diagnostic imaging coverage for beneficiaries with acute Low Back Pain (LBP) within six weeks of symptom onset if there were no warning signs.

If there are clinical warning signs to justify imaging within six weeks of acute low back pain onset, providers should bill with the appropriate secondary diagnosis code.

See the TRICARE Policy Manual (TPM) Chapter 5, Section 1.1 for more information.