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Neurology & Pain Management Coding Alert

Reader Question:

Intent Helps Distinguish SI Injection From Arthrogram

Published on Thu Oct 13, 2011

Question: What is the difference between a sacroiliac (SI) joint injection and an SI joint arthrogram? How do I know the difference when requesting authorization prior to the procedure being rendered?South Carolina SubscriberAnswer: An arthrogram requires a formal radiological interpretation and report that the physician uses for further diagnosis and treatment of the patient. It also requires that hard copies of multiple views of the arthrogram be obtained. In contrast, the fluoroscopic guidance used with a diagnostic and/or therapeutic SI joint injection is used solely for confirming that the needle was accurately placed within the joint capsule; which is far more commonly performed. The Instructions for Use of the CPT® Codebook directs providers that "Reports are the work product of the interpretation of test results. Certain procedures or services described in CPT® involve a technical component (e.g., tests) that produce "results" (e.g., data, images, slides)...Some CPT® descriptors specifically require interpretation [...]
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