CPT 27096 represents the injection of an anesthetic/steroid into the sacroiliac (SI) joint. The most critical rule for this code involves the use of formal imaging guidance.
Fluoroscopy or CT is Mandatory
CPT explicitly states that 27096 requires the use of fluoroscopy or CT guidance (and includes the arthrography). If the physician performs an SI joint injection blindly (without imaging) or using ultrasound, you cannot bill 27096.
If done without fluoro/CT, you must down-code the procedure to CPT 20552 (Trigger point injection, 1-2 muscles).
Medical Necessity & Modifiers
Use Modifier RT or LT to specify which SI joint was injected. If injecting both the left and right SI joints, append Modifier 50.
NCCI Edits
Do not bill 77003 (fluoroscopic guidance) separately with 27096. It is inherently bundled and will trigger an NCCI denial.