Anesthesia Coding Alert

Question: When should I report HCPCS G0260 during a sacroiliac (SI) joint injection procedure, and when should I report 27096?

Alabama Subscriber

Answer: If the physician performs an SI joint injection with fluoroscopy at an ambulatory surgical center, he bills 27096 (Injection procedure for sacroiliac joint, arthrography and/or anesthetic/steroid) and 76005 (Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures [epidural, transforaminal epidural, subarachnoid, paravertebral facet joint, paravertebral facet joint nerve or sacroiliac joint], including neurolytic agent destruction) with modifier -26 (Professional component).

Code 27096 describes two distinct procedures -- one for diagnostic purposes and the other for therapeutic. It is bundled with other codes as a diagnostic service, but it is separately billable as a therapeutic procedure.

G codes related to SI joint injections help complete the reporting and payment picture from the facility's viewpoint. The facility bills G0260 (Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent and arthrography) with modifier -SG (Ambulatory surgical center [ASC] facility service) for the anesthetic agent used during the injection.

Be careful that you don't confuse G0260 with G0259 (Injection procedure for sacroiliac joint; arthrography). G0259 is an incidental-status indicator because injections for arthrography are still bundled into 73542 (Radiologic examination, sacroiliac joint arthrography, radiological supervision and interpretation), but facilities still report it when appropriate to ensure complete record keeping.