tci Outpatient Facility Coding Alert - 2016 Issue 5

Reader Question: Stay Away From 27096 for Outpatient Settings

Question: Do the codes for sacroiliac joint arthrography differ for outpatient and hospital settings? How should we report the procedure? New York Subscriber Answer: When your physician administers injections for sacroiliac joint arthrography, you report code 27096 (Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance [fluoroscopy or CT] including arthrography when performed). This code includes imaging guidance, i.e. fluoroscopy and/or CT used by your physician to confirm the intra-articular needle positioning. However, if your physician administers a sacroiliac joint injection without imaging guidance, you do not submit code 27096. You instead report code 20552 (Injection[s]; single or...

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