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There's some chatter that a group of surgeons is planning an attack on the minimally invasive SIJ fusion code at the next RUC meeting. This would be tantamount to an insurrection against MIS SIJ procedures performed by pain physicians. Can anyone confirm or deny this?
It's past time to mobilize the specialty's resources. This is our Fort Sumter...let's show them what we've got...
"The submitted application recommends that a separate and unique Category III code should be given for MIS SI fusion for the dorsal and posterior approach. We strongly disagree with his assessment. We contend that the existing 27279 code, which has been coded for several years for posterior and posterior/dorsal approach, does not require a specific code. CPT code 27279 further states “percutaneous or minimally invasive” by a description of CPT. The existing code is accurately represented within the current descriptor of 27279. The steps for a posterior MIS SI Fusion approach are equivalent in scope and complexity to the lateral approach except a different angle to approach the joint is used. This code has been utilized and accepted by payers and societies for MIS SI fusions by multiple devices/implants over the last several years utilizing the posterior, posterior/dorsal approach with well-documented clinical outcomes. If the AMA were to limit 27279 CPT code as suggested by Mr. Twetten, only one manufacturer would be represented under the current 27279 CPT code. The open arthrodesis code for sacroiliac joint 27280 does include multiple approaches, as with most codes that can be done either through a percutaneous/minimally invasive vs. open procedure. If the CPT Committee were to issue a code for every procedure that could be performed at a different angle/approach for any existing procedure; this would set a dangerous precedent for coding."
It's past time to mobilize the specialty's resources. This is our Fort Sumter...let's show them what we've got...
"The submitted application recommends that a separate and unique Category III code should be given for MIS SI fusion for the dorsal and posterior approach. We strongly disagree with his assessment. We contend that the existing 27279 code, which has been coded for several years for posterior and posterior/dorsal approach, does not require a specific code. CPT code 27279 further states “percutaneous or minimally invasive” by a description of CPT. The existing code is accurately represented within the current descriptor of 27279. The steps for a posterior MIS SI Fusion approach are equivalent in scope and complexity to the lateral approach except a different angle to approach the joint is used. This code has been utilized and accepted by payers and societies for MIS SI fusions by multiple devices/implants over the last several years utilizing the posterior, posterior/dorsal approach with well-documented clinical outcomes. If the AMA were to limit 27279 CPT code as suggested by Mr. Twetten, only one manufacturer would be represented under the current 27279 CPT code. The open arthrodesis code for sacroiliac joint 27280 does include multiple approaches, as with most codes that can be done either through a percutaneous/minimally invasive vs. open procedure. If the CPT Committee were to issue a code for every procedure that could be performed at a different angle/approach for any existing procedure; this would set a dangerous precedent for coding."
