Wiki 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?
 
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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