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Synvisc injection into Sacroiliac Joint

  1. #1
    Question Synvisc injection into Sacroiliac Joint
    Medical Coding Books
    Any advice on the correct CPT code to assign when the Interventional Radiologist injects Synvisc (in a series of 3 injections on different days) into the Sacroiliac joint using fluoroscopy? This is an off label use of the drug.

    Any references would be greatly appriciated!

  2. Default
    Here is the link to the Synvisc website; it should take you to the billing and reimbursement section. If not, go to and click on healthcare professionals link and you will find the reimbursment link.

    Good luck,

    Dolores, CCC CPC

  3. #3
    Thank you Dolores. Our docs are saying that we should use 27096 Injection procedure for sacroiliac joint, arthrography and/or anesthetic/steroid since the are using the "like" an anesthetic because it relieves pain. I argue that this is not an anesthetic and should go to 20610 major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa) which is what would be used if it was the approved use (injection into the knee). They do not agree with the synvisc website because it only addressed the approved use and not the off label use. Any suggestions?

  4. #4
    I think we should draw a fine line between being a coder and a provider. Being a coder, most importent thing for me is to decide the intent of the provider. Here, if the intent is to inject Synvisc as anethetic or anything, it's provider's discretion. He would be accountable for it ultimately. I would go ahead and code 27096 without hesitation since it is not wrong code too. I hope this helps.
    Girish Dadhich, CPC

  5. Default
    Yes, 27096 with 77002 (if guidance taken) is okay to code for this. Do not get confused by spinal injection in this case the purpose of injection is not to block nerves.

    Rajesh Verma, CPC
    Last edited by rajeshverma607; 10-18-2011 at 06:15 AM.

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