Got coding questions? Your Academy has the answers. Each month we feature a member’s question with an answer provided by AAPM&R’s Reimbursement and Policy Review Committee (RPRC).
Q: What is the appropriate code for billing an SI joint injection?
A: There are 2 possible codes that may be appropriate depending on the kind of imaging guidance you use.
Bill code 27096 for a sacroiliac joint injection when fluoroscopy or CT imaging is used to guide the injection.
Bill code 20552 for a sacroiliac joint injection when ultrasound is used. Since ultrasound is not included in code 20552, you will need to bill for it separately using code 76942 (ultrasonic guidance for needle placement). Additionally, members should check their payer’s policies prior to billing SI joint injection under ultrasound guidance, as it is may be considered a non-covered service. Payers may also provide guidance on billing for bilateral procedures.
Find additional resources related to reimbursement here. Do you have a coding or billing question? Contact AAPM&R at firstname.lastname@example.org for assistance.
Accurate coding is the responsibility of the provider. This article is intended only as a resource to assist in the billing process.