27096 denials

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106
Location
New Hartford, CT
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Beginning in 2012 Medicare has begun denying our SI joint injections for medical necessity. Dx code used is 720.2 which is a payable code per their LCD. Anyone else having this problem, and if so, have you found a solution? Thanks.
 
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99
Location
Muncie, IN
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I am having the same problem with 724.6 which is also located on the Medicare LCD for our location. Please let me know if you have ran across a solution!

Thank you!
Melissa, CPC
 

primrose1

Guru
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120
Location
Albion, NY
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This info is from a webinar I sat in on, not sure if it'll help your situation:

- 27096 for injection procedure for SI joint, anesthetic/steroid with image guidance (fluoro or CT) including arthrography when performed;

- bundled the imaging

- states if you did without imaging it is considered a trigger point 20552. Different from previous recommendations of 20610. States if you don't use imaging, you can't confirm you are in the "joint" so trigger point!


Kris
 
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