Radiology Coding Alert

Question: Which CPT code should we report for a steroid sacro-coccygeal joint injection?

Texas Subscriber

Answer: Many providers consider the sacro-coccygeal joint to be similar in size to the temporomandibular joint and report these joint injections with 20605 (Arthrocentesis, aspiration and/or injection; intermediate joint or bursa [e.g., temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa]).

The sacro-coccygeal joint is the synovial joint between the sacrum and the coccyx (tailbone), a small triangular bone made up of three to five rudimentary vertebrae, which may or may not be fused together.

Providers often perform the injections to the joint for coccydynia (724.79, Other disorders of the coccyx).

Coccydynia can follow after falls, childbirth, repetitive strain, or surgery. In some cases the cause is unknown. Coccydynia pain can disappear by itself or with treatment, or it can continue for years and may get worse.

RS&I: Remember to report the radiological supervision and interpretation (RS&I) separately, based on the modality used:

• 76942 -- Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation

• 77002 -- Fluoroscopic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device)

• 77012 -- Computed tomography guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), radiological supervision and interpretation

• 77021 -- Magnetic resonance guidance for needle placement (e.g., for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation.