Anesthesia Coding Alert

Question: I know that two new codes for sacroiliac injections went into effect this year and that they are supposed to be billed together. Can you explain when we should use each one and what kind of documentation needs to go with them?

California Subscriber

Answer: The new codes are 27096 (injection procedure for sacroiliac joint, arthrography and/or anesthetic/steroid) and 73542 (radiological examination, sacroiliac joint arthrography, radiological supervision and interpretation). These new codes are significant and important for you to know about because sacroiliac (SI) joint injections are such common procedures. Bill 27096 for the procedure itself. You need to have a formal arthrography recorded before you can bill 73542 for the interpretation.

If you do not have a formal report, use code 76005 (fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures [epidural, transforaminal epidural, subarachnoid, paravertebral facet joint, paravertebral facet joint nerve or sacroiliac joint], including neurolytic agent destruction) along with modifier -26 (professional component) for fluoroscopic guidance. These types of injections often are used as a diagnostic tool to determine if the procedural injection will work. Many anesthesiologists performing the injection may not complete a formal report of the procedure, so you may find that many of the injections should be coded as 76005-26.

Source for Reader Questions is Gina Graham, CPC, an anesthesia coding specialist in Hephzibah, Ga., who works for MEDAC billing services in Augusta, Ga.