CPT 27279 · SI Fusion · BCBS Massachusetts
SI Fusion — Minimally Invasive at BCBS Massachusetts.
How BCBS Massachusetts approaches CPT 27279 (SI Fusion — Minimally Invasive) for prior-authorization review: at last review on 2026-04-27, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-04-27
Policy number
MP 320Criteria summary
High-level themes from the BCBS Massachusetts policy of record for CPT 27279. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 24 weeks of conservative care typically required.
- Imaging concordance documentation required.
- Prior Diagnostic intra-articular SI joint injection (CPT 27096/G0260) documentation required (typically with ≥75% relief).
Source: BCBSMA MP 320 — Diagnosis and Treatment of Sacroiliac Joint Pain
See the full BCBS Massachusetts criteria.
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