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27096 denials

  1. Question 27096 denials
    Medical Coding Books
    Beginning in 2012 Medicare has begun denying our SI joint injections for medical necessity. Dx code used is 720.2 which is a payable code per their LCD. Anyone else having this problem, and if so, have you found a solution? Thanks.
    Ann Marie CPC
    Watertown, CT

  2. #2
    I am having the same problem with 724.6 which is also located on the Medicare LCD for our location. Please let me know if you have ran across a solution!

    Thank you!
    Melissa, CPC

  3. Default
    This info is from a webinar I sat in on, not sure if it'll help your situation:

    - 27096 for injection procedure for SI joint, anesthetic/steroid with image guidance (fluoro or CT) including arthrography when performed;

    - bundled the imaging

    - states if you did without imaging it is considered a trigger point 20552. Different from previous recommendations of 20610. States if you don't use imaging, you can't confirm you are in the "joint" so trigger point!


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