Billing and Coding: Minimally-invasive Surgical (MIS) Fusion of the Sacroiliac (SI) Joint

Coverage for minimally-invasive sacroiliac (SI) joint fusion requires documentation of medical necessity consistent with the related Local Coverage Determination (LCD), including history, physical exam, and diagnostic test results. Claims must include a valid ICD-10-CM diagnosis code, and billing must comply with NCCI/OPPS edits; referring/ordering physician name and NPI must be reported when required, and medical records must be available to Medicare on request.

"Minimally-invasive surgical fusion of the sacroiliac (SI) joint is covered when the patient's medical record documents medical necessity per the related Local Coverage Determination (LCD), includin..."

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