Posted By Pinky Maniri in Pain Management Coding and Billing |

How to Bill and What is the CPT Code for Sacroiliac Fusion

Disclaimer: These are current codes. Please make sure you read your Operative Report before assigning any of these codes (CPT and HCPCS). Make sure you identify Medical Necessity, knows the Utilization and Reimbursement Guidelines. Be careful when assigning Diagnosis codes to meet medical necessity to avoid claims denials and rejection. Most of these procedures will need Prior Authorization, always verify benefits and eligibility before you render service. Have an approval or referral before you render service.

These are your codes:

CPT CODE 27279 Arthrodesis, sacroiliac joint, percutaneous or minimally invasive (indirect visualization), with image guidance, includes obtaining bone graft when performed, and placement of transfixing device
CPT CODE 27280 Arthrodesis, open, sacroiliac joint, including obtaining bone graft, including instrumentation, when performed

CPT is a trademark and owned by the American Medical Associations
References we used: 2018-2019 CPT Codes Books (CPT, ICD-10, HCPCS)
Current Guidelines from Payers including from Medicare and Medicaid if available