Question Sacroiliac Joint Injection with Ultrasound Guidance

taty313

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I am having a hard time getting pay by Medicare for SIJ injections performed at the office with ultrasound guidance. We are using 20552, 76942 with Dx: M53.3

Per CPT guidelines, if ultrasound is used instead of fluoroscopy or CT, report a trigger point injection code 20552 (Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)) and 76942 (Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation). CPT code 20552 is reported one time, whether the procedure is performed as a unilateral or bilateral procedure. Remember, CPT code 76942 has a professional and technical component; in the ASC setting you will append modifier 26 assuming the procedure note includes the required documentation for US guidance.

What CPT code should be used?
 

vzayicek

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We have had success with 20552 and 76942 with M25.59 - pain specified joint. This is on our LCD in South Carolina.
 
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