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Sacroiliac Joint Fusion

Phyllis Posted Tue 10th of June, 2014 15:41:13 PM

One of our physicians provided anesthesia for a sacroiliac joint fusion using Medtronic Rialto Device with morselized allograft. The surgeon used the new Category III CPT 0334T, which in the ASA Crosswalk, crosses to 01936 for 5 units, or alternate 01160 for 4 units. The anesthesiologist feels that since the procedure included instrumentation, anesthesia code 00670 for 13 units should apply. According to the operative report, "We were able to sequentially tap starting at 4.5 mm all the way up to the 7.5 mm awl-tipped tap, and then we were able to tap with the specific tap for the Medtronic Rialto device. Once we tapped to an appropriate size, we chose an appropriate length Medtronic Rialto threaded fenestrated cage and packed this cage with Grafton allograft putty, and then we were able to screw the device through the iliac bone, across the SI joint bone, and into the sacral area." How should we code the case?

SuperCoder Answered Thu 12th of June, 2014 03:31:53 AM

You should report 01936 for 5 units, or alternate 01160 for 4 units with Category III CPT 0334T.

0334T specifically designated for SI joint fusion performed with minimally invasive or percutaneous approaches. The surgical instrumentation performed by your surgeon for SI joint fusion is usually considered as part of 0334T. Moreover, 00670 is used with extensive spine and spinal cord procedures that are performed through open approach. Minimally invasive SI joint fusion using Medtronic Rialto Device will not qualify for 00670.

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