CPT 27279 · SI Fusion · Aetna Better Health of New Jersey
SI Fusion — Minimally Invasive at Aetna Better Health of New Jersey.
How Aetna Better Health of New Jersey approaches CPT 27279 (SI Fusion — Minimally Invasive) for prior-authorization review: at last review on 2026-05-06, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-05-06
Policy number
CPB 0016Criteria summary
High-level themes from the Aetna Better Health of New Jersey policy of record for CPT 27279. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 26 weeks of conservative care typically required.
- Imaging concordance documentation required.
- Prior Two diagnostic image-guided SIJ injections (CPT 27096) at the target joint documentation required (typically with ≥75% relief).
See the full Aetna Better Health of New Jersey criteria.
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