Wiki SI Joint Injections

[mcduffiegal]

We are having a discussion in my office about the correct coding for a non-image guidance in office SI joint injection. 1 coder says 20610 and the other says 20552. What is the correct CPT code?

 

[RyanRaichCPC]

Per the CPT book, if image guidance is not used CPT 20552 should be reported.

 

[thomas7331]

20610 is the correct code for an injection into the SI joint. 20552 is a trigger point injection, which is an injection of a muscle, not the joint.

 

[RyanRaichCPC]

20610 is the correct code for an injection into the SI joint. 20552 is a trigger point injection, which is an injection of a muscle, not the joint.

I am just going off of what my CPT book says which per guidelines, we are to go where the book directs us. CPT book states " 27096 is to be used only with CT or fluoro imaging confirmation of intra-articular placement of needle positioning. If CT or fluoro is not performed, use 20552. "

I completely agree that SI is a major joint and not a muscle, however the directions in the CPT book are pretty clear cut. Anyone else have an opinion?

 

[Bfosbrink15]

I am just going off of what my CPT book says which per guidelines, we are to go where the book directs us. CPT book states " 27096 is to be used only with CT or fluoro imaging confirmation of intra-articular placement of needle positioning. If CT or fluoro is not performed, use 20552. "

I completely agree that SI is a major joint and not a muscle, however the directions in the CPT book are pretty clear cut. Anyone else have an opinion?

I agree, 20552. Encoder states the same thing "For the injection procedure without CT or fluoroscopic imaging guidance, see 20552".

 

[RyanRaichCPC]

The rationale behind using 20552 is because without actual image confirmation of needle placement, there is no guarantee that the actual intra-articular space is being reached, therefore, not a true joint injection.

 

[thomas7331]

The rationale behind using 20552 is because without actual image confirmation of needle placement, there is no guarantee that the actual intra-articular space is being reached, therefore, not a true joint injection.

Yes, my mistake above, I answered too quickly without looking carefully - I agree per the CPT instructions that 20552 should be used if no imaging guidance was used. Thanks for clarifying.