Premera Blue Cross of Washington prior authorization 27279

Premera Blue Cross of Washington prior authorization for 27279: Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of transarticular device(s) and/or intra-articular device(s) piercing the lateral or medial cortices of the ilium and the lateral cortex of the sacrum

Code: 27279
Description: Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of transarticular device(s) and/or intra-articular device(s) piercing the lateral or medial cortices of the ilium and the lateral cortex of the sacrum
Source: Clinical Review by Code List PBCWA, Pg 267 Original policy

Premera Blue Cross of Washington prior authorization

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