Billing and Coding: Sacroiliac Joint Injections and Procedures

This policy provides billing and coding guidance for sacroiliac joint injections and sacral nerve blocks: diagnostic injections require KX modifier and are limited to no more than 2 diagnostic sessions, while therapeutic injections are limited to 4 sessions per rolling 12 months. ASC and OPPS facility billing must use HCPCS G0260 with documented image guidance and should not bill CPT 27096 for facility claims; use of non–FDA-approved biological injectants may result in claim denial.

"Diagnostic sacroiliac joint injections (SIJI) and sacral nerve blocks (initial diagnostic injections) are covered and should be billed with the KX modifier for the initial diagnostic injection(s)."

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