Orthopedic Coding Alert

Question: The provider performs minimally invasive percutaneous arthrodesis of the sacroiliac joint. I’m having trouble deciding between 27279 and 0775T for this procedure. Can you shed any light on reporting these two codes?

AAPC Forum Subscriber

Answer: The confusion you feel is probably common. In fact, CPT^® has included this information in the Arthrodesis section that houses the 27279 (Arthrodesis, sacroiliac joint, percutaneous or minimally invasive (indirect visualization), with image guidance, includes obtaining bone graft when performed, and placement of transfixing device) code.

On your claim, you’ll choose between 27279, 27299 (Unlisted procedure, pelvis or hip joint), and 0775T (Arthrodesis, sacroiliac joint, percutaneous, with image guidance, includes placement of intra-articular implant(s) (eg, bone allograft[s], synthetic device[s])).

The difference: Per CPT^®, “Code 27279 describes percutaneous arthrodesis of the sacroiliac joint using a minimally invasive technique to place an internal fixation device(s) that passes through the ilium, across the sacroiliac joint and into the sacrum, thus transfixing the sacroiliac joint.

“Report 0775T for the percutaneous placement of an intra-articular stabilization device into the sacroiliac joint using a minimally invasive technique that does not transfix the sacroiliac joint.”

1 more thing: Again per CPT^®, “For percutaneous arthrodesis of the sacroiliac joint utilizing both a transfixation device and intra-articular implant(s), use 27299.”