2023 ASC Coding Tips: Sacroiliac Joint Fusions

By Kris Brown, RHIT, CPC, CPMA, CASCC, Senior Coding Manager

The American Medical Association (AMA) created two new codes to capture the different locations where implants are placed in percutaneous sacroiliac joint fusions. Previously, the only code option was CPT 27279, which was specific to the placement of a transfixing device. While the code descriptions of the original code and new codes appear similar, understanding the key differences between them is essential for proper code selection.

Original code: CPT 27279 (Arthrodesis, sacroiliac joint, percutaneous or minimally invasive (indirect visualization), with image guidance, includes obtaining bone graft when performed, and placement of transfixing device) (emphasis added)

• Explanation: An implant is advanced across the ilium, across the SI joint, and into the sacrum.

New code: CPT 0775T (Arthrodesis, sacroiliac joint, percutaneous, with image guidance, includes placement of intra-articular implant(s) (eg, bone allograft[s], synthetic device[s]) (emphasis added)

• Explanation: The implants are placed intra-articular (within the joint).

New code: CPT 0809T (Arthrodesis, sacroiliac joint, percutaneous or minimally invasive (indirect visualization), with image guidance, placement of transfixing device(s) and intraarticular implant(s), including allograft or synthetic device(s)) (emphasis added)

• Explanation: Implants are placed across the joint (transfixed) and intra-articular to fuse the joint. This code combines the methods of fusion in both 27279 & 0775T into a single code.

"Unlisted" code: CPT 27299 (Unlisted procedure, pelvic or hip joint)

• Explanation: If implants are used in any other method or placement other than described as above, it is reported with unlisted code 27299.
  • Example: The implant spans the sacroiliac joint and rests partially into the ilium and partially into the sacrum. The implant is neither transfixing the joint nor intra-articular.