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A radiologic examination of the sacroiliac (SI) joints involves the use of X-ray imaging to visualize the area where the left and right winged pelvic bones connect with the sacrum, forming the posterior aspect of the pelvic ring. This examination is crucial due to the complex anatomy and irregular surfaces of the SI joints, which can pose challenges for imaging. The procedure typically begins with an anteroposterior (AP) view, where the patient is positioned supine with knees or hips flexed, if feasible. Following this, left and right oblique views are obtained with the patient recumbent and rotated approximately 25-30 degrees from the AP position. It is important to note that while the oblique views capture the side that is elevated, the patient is actually positioned for the opposite side to be down. Additionally, posteroanterior views may be taken with the patient in a prone position. The primary purpose of this radiologic examination is to assist in diagnosing various conditions, including spondyloarthropathies associated with rheumatic diseases, inflammatory lesions affecting the SI joint, sacroiliitis, ankylosing spondylitis, juvenile spondyloarthropathy, arthritis linked to inflammatory bowel disease, psoriatic arthritis, reactive arthritis, as well as potential fractures or dislocations. The X-ray imaging technique utilizes indirect ionizing radiation to create images of internal structures by exploiting the varying densities and compositions of human tissue, resulting in a two-dimensional representation of the anatomical features. If fewer than three views are captured during the examination, the appropriate code to report is 72200, whereas for three or more views, code 72202 should be utilized for a comprehensive examination.
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The radiologic examination of the sacroiliac joints is indicated for the following conditions:
The procedure for the radiologic examination of the sacroiliac joints involves several key steps to ensure accurate imaging. First, the patient is positioned supine for the anteroposterior (AP) view, which is typically the initial view taken. The patient's knees or hips may be flexed to enhance the visibility of the SI joints. Following the AP view, the patient is then rotated approximately 25-30 degrees from the AP position to obtain the left and right oblique views. It is important to note that while the oblique views capture the side that is elevated, the patient is actually positioned for the opposite side to be down. This positioning is crucial for obtaining clear images of the SI joints. In some cases, posteroanterior views may also be taken with the patient in a prone position to provide additional perspectives of the joints. The radiologic technologist ensures that the X-ray machine is properly aligned and that the appropriate settings are used to capture high-quality images. The entire process is designed to provide comprehensive imaging of the sacroiliac joints, aiding in the diagnosis of various conditions affecting this area.
After the radiologic examination of the sacroiliac joints, the patient may be advised to resume normal activities unless otherwise directed by the physician. There are typically no specific post-procedure care requirements, as the procedure is non-invasive and involves minimal discomfort. The images obtained will be reviewed by a radiologist, who will interpret the findings and provide a report to the referring physician. The physician will then discuss the results with the patient and determine any necessary follow-up actions or treatments based on the findings from the examination. It is important for the patient to communicate any ongoing symptoms or concerns during this follow-up appointment.
| Short Descr | X-RAY EXAM SI JOINTS | Medium Descr | RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS | Long Descr | Radiologic examination, sacroiliac joints; less than 3 views | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | STV-Packaged Codes | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I1B - Standard imaging - musculoskeletal | MUE | 2 | CCS Clinical Classification | 226 - Other diagnostic radiology and related techniques |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | LT | Left side (used to identify procedures performed on the left side of the body) | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | FY | X-ray taken using computed radiography technology/cassette-based imaging | GC | This service has been performed in part by a resident under the direction of a teaching physician | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | CT | Computed tomography services furnished using equipment that does not meet each of the attributes of the national electrical manufacturers association (nema) xr-29-2013 standard | FX | X-ray taken using film | GA | Waiver of liability statement issued as required by payer policy, individual case | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | KX | Requirements specified in the medical policy have been met | PC | Wrong surgery or other invasive procedure on patient | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q5 | Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | QJ | Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b) | RT | Right side (used to identify procedures performed on the right side of the body) | X2 | Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2013-01-01 | Changed | Description Changed |
| 2009-01-01 | Changed | Code description changed |
| Pre-1990 | Added | Code added. |
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