November 14, 2019
My MD performed an SI joint injection with ultrasound guidance in the office. What is the appropriate coding for this procedure? I have seen information regarding not using 27096 (SI joint injection) and using 20552 (trigger point injections) with 76942 (ultrasound guidance) instead. Which is correct?
If using ultrasound instead of fluoroscopy or CT for the SI joint injection, you should report a trigger point injection with 76942. However, double check your payor policy as some payors exclude payment of 27096 with ultrasound. Make sure you also append Modifier 26 if you do not own the equipment and are proving only the professional component (interpretation).
*This response is based on the best information available as of 11/14/19.