Sacroiliitis, not elsewhere classified. M46.1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
How to Do It
Remember, not everyone with SI joint pain needs surgery, but if you do have SI joint pain and have tried non-surgical treatments (and they haven’t reduced your pain), know that SI joint fusion may be able to help address your pain and other symptoms.
Sacroiliac joint pain can be difficult to diagnose as other conditions can cause similar symptoms. Sacroiliac joint pain is most commonly felt in the low back and buttock but can also be referred into the thigh and leg. If numbness and tingling or weakness is present, an alternative diagnosis should be considered.
The sacroiliac joints link your pelvis and lower spine. They're made up of the sacrum — the bony structure above your tailbone and below your lower vertebrae — and the top part (ilium) of your pelvis. There are sacroiliac joints in both the right and left sides of your lower back.
Overview. Sacroiliac (SI) joint pain is felt in the low back and buttocks. The pain is caused by damage or injury to the joint between the spine and hip. Sacroiliac pain can mimic other conditions, such as a herniated disc or hip problem. Accurate diagnosis is important to determine the source of pain.
ICD-10 code: M46. 1 Sacroiliitis, not elsewhere classified.
3: Sacrococcygeal disorders, not elsewhere classified.
Radiculopathy, sacral and sacrococcygeal region M54. 18 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
Sacroiliac Joint Location The articulation between the outer side of the spine's sacrum and the inner side of the butterfly-shaped hip bone (ilium) forms the sacroiliac joint. The SI joints are located on either side of the sacral spine and are situated deep in the pelvis.
M25. 559 - Pain in unspecified hip. ICD-10-CM.
ICD-10 code M46. 1 for Sacroiliitis, not elsewhere classified is a medical classification as listed by WHO under the range - Dorsopathies .
Therefore, it is clear the existing CPT code 27280 describes an open SI joint fusion procedure from multiple different approaches and that CPT code 27279 has been established to describe MIS SI joint procedures that utilize a lateral transiliac approach (Table 1).
ICD-10 code R10. 2 for Pelvic and perineal pain is a medical classification as listed by WHO under the range - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified .
9: Dorsalgia, unspecified.
ICD-10 code G89. 29 for Other chronic pain is a medical classification as listed by WHO under the range - Diseases of the nervous system .
Proper coding is 20553, 76942.
Why Inject the SI? SI joint dysfunction generally refers to pain caused by abnormal motion (too much or too little) in the SI joint, which in turn results in inflammation of the joint (sacroiliitis). The purpose of a SI joint injection is two-fold:
Diagnostic: SI joint injection is used to confirm a suspected diagnosis of sacroiliac joint dysfunction. A local anesthetic (usually lidocaine or bupivacaine) typically is injected into the joint, with the goal of determining immediate pain relief to confirm the SI joint as the pain’s source.
Sacroiliac (SI) joint injection, or SI joint block, is used primarily either to diagnose or to treat low-back pain, and/or sciatica associated with SI joint dysfunction. Coding for this procedure is relatively straightforward, if you consider imaging and/or the proper use of modifier 50 Bilateral procedure.
SI injection is a minor procedure, usually performed in an operating or dedicated procedure room. After informed consent has been obtained, the patient lies face down on his or her stomach on the radiography table. A pillow might be placed under the hips for patient comfort.
In this case, you cannot bill the SI joint injection separately .
Do not report the guidance separately: It’s included in 27096. If an arthrogram is performed along with the injection, the arthrogram is not separately reportable. Note that 27096 is a unilateral procedure. For bilateral injection, you may append modifier 50.
For dates of service on or after 01/01/2020, dry needling should be reported using CPT codes 20560 or 20561. Effective January 21, 2020, Medicare will cover all types of acupuncture including dry needling for chronic low back pain within specific guidelines in accordance with NCD 30.3.3.
The use of an ICD-10-CM code listed below does not assure coverage of a service. The service must be reasonable and necessary in the specific case and must meet the criteria specified in the attached determination.