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SI joint injection coding help

  1. #1
    Question SI joint injection coding help
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    Hi all! I code for ASC's and have one physician in particular that performs both and inferior and superior sacroiliac joint injections, unilaterally. For instance, he'll access the inferior aspect of the right SI joint, inject an anesthetic/steroid mix, then insert a new needle into the superior aspect of the right SI joint and inject the same mixture (volume/drugs) into that area. I was previously told that this would constitute two sites and therefore I should code 27096-rt & 27096-rt-59. Now, I'm being told it should be just the once. Any help/info would be GREATLY appreciated.

  2. #2
    Default SI joint injection
    Quote Originally Posted by kandimcm View Post
    Hi all! I code for ASC's and have one physician in particular that performs both and inferior and superior sacroiliac joint injections, unilaterally. For instance, he'll access the inferior aspect of the right SI joint, inject an anesthetic/steroid mix, then insert a new needle into the superior aspect of the right SI joint and inject the same mixture (volume/drugs) into that area. I was previously told that this would constitute two sites and therefore I should code 27096-rt & 27096-rt-59. Now, I'm being told it should be just the once. Any help/info would be GREATLY appreciated.
    I was under the impression this was per joint, not per injection. So, since you are injecting into the same joint, I would only code once. Anyone else?
    Anna Weaver, CPC, CPMA, CEMC
    Associate Auditor

  3. #3
    Location
    Seattle First Hill
    Posts
    126
    Default
    Per CCI, it looks like it can be billed bilaterally...

  4. #4
    Location
    North Carolina
    Posts
    3,126
    Default
    I believe it's the same side... (?)

    "inferior aspect of the right SI joint, inject an anesthetic/steroid mix, then insert a new needle into the superior aspect of the right SI joint "

  5. #5
    Location
    albuquerque
    Posts
    93
    Smile
    he is only injecting one joint, therefore one code.
    Angelica Stephens RHIT, CPMA, COSC, CCS-P, CPC, COC.
    Albuquerque, NM

  6. #6
    Default
    thank you all for the information! does it make a difference that I am coding for the facility and not the physician? We were told to code per surgical site and as he's inserting two different needles into two different sites (inferior/ superior) that's what I was doing. thanks again for all your help!

  7. Angry anyone having issues with BC/BS denying 27096?
    they are stating this is experimental. Anyone else facing this? What can be done for the patient?

    HELP

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