Sacroiliac Joint Fusion

image_pdfimage_print

Question:

My spine surgeon is doing a new procedure called SI Joint Fusion and it’s a minimally invasive procedure he does under fluoroscopy. The vendor rep told us to bill 27280. You’ve always told us to be skeptical of coding recommendations from outside sources so we wanted to confirm with you if this is the correct code.

Answer:

Yay – someone finally listened to us!! Thank you for asking the question because you have been given misleading advice. CPT 27280 says “Arthrodesis, sacroiliac joint (including obtaining graft)” and describes a complex and open procedure requiring several days in the hospital for recovery. The minimally invasive, SI Joint Fusion procedure you describe is a new minimally invasive procedure performed typically as a day surgery. This procedure did not have a CPT code until recently. Historically we used an unlisted code such as 22899 for the procedure. However, the following Category III code was implemented on July 1, 2013 for this procedure:

0334T Sacroiliac joint stabilization for arthrodesis, percutaneous or minimally invasive (indirect visualization), includes obtaining and applying autograft or allograft (structural or morselized), when performed, includes image guidance when performed (eg, CT or fluoroscopic)

Survey your payors to see if it is a covered procedure because many insurance companies do not reimburse this code.