Radiology Coding Alert

Question: Our physician performed a left SI joint injection under lateral fluoroscopic view. Can we submit procedure codes 62311 and 77003? Can we also append modifier 51 or 59 to the code 77003? 

New Mexico Subscriber

Answer: The more appropriate code for the SI injection under fluoroscopy is 27096 (Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance [fluoroscopy or CT] including arthrography when performed). This code describes your provider’s service more accurately. This code is inclusive of image guidance. Hence, you will not need to separately report any fluoroscopy code. 

Check for imaging: You should only report 27096 when your provider uses CT or fluoroscopic imaging to confirm intra-articular needle positioning. If he doesn’t use CT or fluoroscopy imaging, report 20552 (Injection[s]; single or multiple trigger point[s], 1 or 2 muscle[s]) instead. 

Use modifiers: Remember that 27096 is a unilateral procedure. For bilateral injections, you append modifier 50 (Bilateral procedure).

The codes 62311 (Injection[s], of diagnostic or therapeutic substance[s] [including anesthetic, antispasmodic, opioid, steroid, other solution], not including neurolytic substances, including needle or catheter placement, includes contrast for localization when performed, epidural or subarachnoid; lumbar or sacral [caudal]) and 77003 (Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures [epidural or subarachnoid]) are not specific for SI joint injections under fluoroscopic guidance. You should not be reporting these codes for the procedure described.