Billing and Coding: Minimally Invasive Arthrodesis of the Sacroiliac Joint (SIJ)

This billing and coding guidance supplements LCD L39797 for minimally invasive sacroiliac joint arthrodesis: claims must meet the LCD's medical necessity criteria and include a valid ICD-10-CM diagnosis code. Procedure codes may be subject to NCCI and OPPS edits; when a referring physician is required include their name and NPI, and medical records (history, physical exam, and diagnostic results) must document and support medical necessity and be available to Medicare upon request.

"Minimally invasive arthrodesis of the sacroiliac joint is billable when the service meets the coverage and medical necessity criteria in Local Coverage Determination L39797."

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