Medical Coding and billing - Physicians often perform sacroiliac (SI) joint injections to help diagnose or cure SI joint pain. You have to know whether the physician performed the injection to diagnose SI joint dysfunction or to treat joint pain if you want to code the service correctly. Step 1: Understand SI Joint Anatomy and Pain The sacroiliac joint lies next to the spine and connects the sacrum (the triangular bone at the base of the pelvis) to the pelvis (iliac crest). The SI joint is small but very strong; it acts as a shock absorber between upper and lower body forces and is mainly used for stability rather than motion. However, a small bit of motion does occur at the joint, which can lead to pain if the joint becomes locked in position.
Long, large ligaments provide additional stability around the SI joint. These ligaments connect to a variety of muscles including the piriformis, gluteus maximus and minimus, erector spinae, latissimus dorsi and more. Any of these muscles can be involved with a painful SI joint.
The SI joint itself is pain-sensitive because it has many free nerve endings within it. Having so many nerve endings and associated ligaments and muscles means that the physician can't always determine a definite cause of most SI joint pain. Many physicians believe that the culprit may be a change in the joint's normal motion - this source of pain can be caused by either too much movement (hypermobility or instability) or too little movement (hypomobility or fixation). Falls, sprains, sports injuries, tailbone injuries, and obesity often contribute to SI joint pain.
The patient generally feels pain on one side of the low back or buttocks, and sometimes down into the leg. Pain usually remains above the knee but extends to the ankle or foot in some cases. Step 2: Code the Diagnosis Correctly Common symptoms of
SI joint dysfunction include tailbone pain and pain radiating down the leg or into the hip or groin. Even everyday activities become painful when the SI joint is affected, says Tonia Raley, CPC, claims processing manager with Medical Information Management Solutions in Phoenix. The patient often has aching and stiffness in the lower back, and activities such as sitting, climbing stairs, driving and walking can aggravate the pain. Muscle spasms of the back are also common.
Sometimes pain is immediate and keeps the patient from sleeping, walking or doing other normal activities. Patients in this situation are seen immediately so the physician can make a diagnosis and begin treatment. Other patients aren't diagnosed and treated until later because they have increased [...]
