Eli's Rehab Report

Question: Our physiatrist performed an SI joint injection without arthrography or fluoroscopy. Should we use CPT 27096 (Injection procedure for sacroiliac joint, arthrography and/or anesthetic/steroid) with the reduced services modifier (modifier -52)?

Pennsylvania Subscriber

Answer: No, 27096 is not appropriate, even if you append modifier -52. A note in CPT states, "27096 is to be used only with imaging confirmation of intra-articular needle positioning." Therefore, since your physiatrist is not using imaging confirmation, you should not bill this code.

The more appropriate code is 20610* (Arthrocentesis, aspiration and/or injection; major joint or bursa [e.g., shoulder, hip, knee joint, subacromial bursa]).

Although the sacroiliac joint is not listed as an example, it is considered a major joint.