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Old 07-05-2012, 12:10 PM
amaston@ortho amaston@ortho is offline
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Unhappy what code do i use for sacroplasty

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?
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Old 07-05-2012, 12:38 PM
jmcpolin jmcpolin is offline
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The code for sacroplasty is 0200T unfortunately. Hopefully if this gets billed enough they will make a permanent code.
Jenifer McPolin CPC, CPMA, RCC
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Old 07-19-2012, 02:40 PM
maryc@trgltd.com maryc@trgltd.com is offline
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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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