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Medical Policy Revision: Sacroiliac Joint Fusion/Stabilization

Effective August 1, 2018, Horizon Blue Cross Blue Shield of New Jersey will change the way we consider certain professional claims related to the surgical fusion of the iliac bone to the spine for stabilization.

We encourage you to visit our Medical Policy Manual to review the guidelines of our medical policy, Sacroiliac Joint Fusion/Stabilization.


Based on the guidelines of our medical policy, Sacroiliac Joint Fusion/Stabilization, and the submitted diagnosis code(s), claims for services provided on and after August 1, 2018 will be processed as follows:
 

  • CPT® codes 27279 and/or 27280 may be denied as services not related to the submitted diagnosis code(s).
     

Unless Horizon BCBSNJ gives written notice that all or part of the above changes have been cancelled or postponed, the changes will be applied to claims for dates of service on and after August 1, 2018.

CPT® is a registered mark of the American Medical Association.

Published on: May 2, 2018, 11:47 AM ET
Last updated on: May 2, 2018, 11:48 AM ET