Results 1 to 6 of 6

SI joint injection 27096 wo fluoro guidance

  1. Question SI joint injection 27096 wo fluoro guidance
    Medical Coding Books
    How would you code an SI joint injection (27096) without fluoroscopic guidance? If my doctor does it in the office. I have heard some say to code the large joint injection 20610? Is this accurate? RVU of 27096 is 3 times more than 20610.

    Then what if the doctor does a facet joint injection (64475) without fluoroscopic guidance? Would you just code a joint injection? Is the spinal facet a large joint 20610 or medium joint 20605?

    Is there an even better way to code these scenarios????

  2. #2
    Location
    North Carolina
    Posts
    3,126
    Default
    Question

    If an injection is administered into the sacroiliac (SI) joint without fluoroscopic imaging guidance, would it be appropriate to report code 20610 or code 27096?

    AMA Comment

    From a CPT coding perspective, if an injection is administered into the SI joint without fluoroscopic imaging guidance, then it would be appropriate to report code 20610, Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa), for the injection administered into the SI joint without fluoroscopic imaging guidance. Doing it blindly is injecting the L5-S1 facet joint.

    The first parenthetical under 27096 clearly makes this point, ie, 27096 is to be used only with imaging confirmation of intra-articular needle positioning.

    It would not be appropriate to report code 27096, Injection procedure for sacroiliac joint, arthrography and/or anesthetic/steroid, as fluoroscopic guidance is crucial to identify the optimal site for access to the joint. Code 27096 should only be reported when imaging confirmation of intra-articular needle position has been performed


    I once read that a facet joint is considered intermediate. I'm still looking for this information

  3. Default
    Rebecca, Thank you so much for this AMA comment. Where is it published so I have a reference point?

  4. #4
    Location
    North Carolina
    Posts
    3,126
    Default
    CPT Assistant, April 2004 / Volume 14, Issue 04

  5. Default
    Thank you very, very much!

  6. Default
    If you look in your CPT book at code 27096 you will see that, in parentheses, under the code the direction is: (If CT or fluoroscopy imaging is not performed, use 20552). So, 27096 is with imaging and 20552 is without. If imaging is performed, then the provider knows that they have entered the joint space, if imaging is not used then the provider is uncertain that they have entered the joint space, therefore a joint injection cannot be coded and procedure 20552 - trigger point injection is the appropriate code, per our CPT book.
    Last edited by hawk9er; 03-13-2015 at 10:59 AM.

Similar Threads

  1. Need help with SI joint injection w/ultrasound guidance
    By nsteinhauser in forum Anesthesia
    Replies: 4
    Last Post: 07-04-2014, 10:58 AM
  2. Fluoro guidance?
    By bda23054 in forum General Surgery
    Replies: 1
    Last Post: 03-27-2013, 12:25 PM
  3. 77003 Fluoro guidance
    By SWheeldon in forum Interventional Radiology
    Replies: 1
    Last Post: 03-15-2013, 05:30 AM
  4. No guidance with facet joint injection
    By TammyVan in forum Neurology/Neurosurgery
    Replies: 1
    Last Post: 12-10-2012, 07:15 AM
  5. Replies: 1
    Last Post: 01-04-2011, 02:59 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.