ICD-hyphen10 codes covered if selection criteria are met: M54.50 -hyphen M54.59 Low back pain M79.10 -hyphen M79.18 Myalgia ICD-hyphen10 codes not covered for indications listed in the CPB: R10.2 Pelvic and perineal pain Sacroiliac joint injections: CPT codes covered if selection criteria are...