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what code do i use for sacroplasty

  1. Unhappy what code do i use for sacroplasty
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    i have an orthopedic physician that likes to use 27280 for sacroplasty. we are getting denials for this. the only code i found was 0200T, but this is a Category III and medicare will not pay. so he wants a code that will. can anyone help me with this? could i use 22899 with reference to code 22521?

  2. #2
    Salt Lake City
    The code for sacroplasty is 0200T unfortunately. Hopefully if this gets billed enough they will make a permanent code.

  3. Default ....careful!

    I agree with Jenifer's guidance. The cat III code 0200T is the appropriate way to report sacroplasty. Clearly, if you're concerned with payment, you may want to contact NASS for a position statement on Sacroplasty. If favorable, any payor (including Medicare) would be hard pressed to maintain a denial.

    As an FYI, CPT 27280 is getting a lot of attention in recent months as several new procedures are laying claim to it.

    Good luck,

    Mary Corkins
    Mary Corkins
    The Reimbursement Group (TRG)

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