Wiki 27096 CPT CODE FOR ASC

[ebelleville]

I'M NEW TO CODING AND BILLING AND STRUGGLING WITH GETTING REIMBURSED ON THIS INJECTION, PLEASE HELP!

PATIENT HAD A BILATERAL SACROILIAC JOINT INJECTION UNDER CONTINUOUS FLUOROSCOPY. HOWEVER, WE DO NOT HAVE ANY IMAGES DOCUMENTED FROM THIS PROCEDURE. CAN I STILL CODE WITH 27096?

HERE'S HOW WE CODED/BILLED:
ONE LINE:
CPT CODE 27096 MOD: SG 50 UNITS: 1

SHOULD I BE INCLUDING 2 UNITS EVEN WITH THE 50 MODIFIER?

INSURANCE IS TRIWEST NOT MEDICARE

 

[sandraclark5123@gmail.com]

I do believe Triwest goes by Medicare guidelines, so you should be billing G0260 RT & G0260 LT. Do not use a 59 modifier on either code. That is the Medicare code for a SI injection. My coworker is very familiar with these codes and this is what she says. Hope this helps.

 

[ebelleville]

I do believe Triwest goes by Medicare guidelines, so you should be billing G0260 RT & G0260 LT. Do not use a 59 modifier on either code. That is the Medicare code for a SI injection. My coworker is very familiar with these codes and this is what she says. Hope this helps.

I will give this a go, thank you so much!

 

[ebelleville]

I do believe Triwest goes by Medicare guidelines, so you should be billing G0260 RT & G0260 LT. Do not use a 59 modifier on either code. That is the Medicare code for a SI injection. My coworker is very familiar with these codes and this is what she says. Hope this helps.

Hey I just wanted to give you a quick update that this did work for me. Thank you so much!