Neurology & Pain Management Coding Alert

Question:

Mississippi Subscriber

Begin with 27096 (Injection procedure for sacroiliac joint, arthrography and/or anesthetic/steroid) for the SI injection. Because your specialist administered bilateral injections, check the payer's policy regarding how to report the service. Some payers require you to append modifier 50 (Bilateral procedure) to 27096 to indicate bilateral injections. Other payers require 27096 on two separate lines on the claim, with modifier LT (Left side) appended to one and modifier RT (Right side) appended to the other.

Report the fluoroscopic guidance with CPT 77003 (Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures [epidural, subarachnoid, or sacroiliac joint], including neurolytic agent destruction). CPT^® guidelines direct you to report 77003 once per spinal region (cervical, thoracic, lumbar, sacral). Correct Coding Initiative (CCI) guidelines direct you to report 77003 once per procedure. You should only report 77003 once in this situation, no matter which guidelines you're following.

Heads up: Coding for this situation will change once CPT^® 2012 goes into effect on Jan. 1, 2012. The services represented by 77003 will be included in the code descriptor for 27096, so you'll only report 27096.