CPT 27279 · SI Fusion · BCBS Tennessee
SI Fusion — Minimally Invasive at BCBS Tennessee.
How BCBS Tennessee approaches CPT 27279 (SI Fusion — Minimally Invasive) for prior-authorization review: at last review on 2026-04-09, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-04-09
Policy number
BCBS-TN MPM (SI Joint Pain) ID_BACriteria summary
High-level themes from the BCBS Tennessee 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 Diagnostic SI joint injection(s) confirming SI joint as pain generator documentation required (typically with ≥50% relief).
Source: BCBS-TN Medical Policy — Diagnosis and Treatment of Sacroiliac Joint Pain
See the full BCBS Tennessee criteria.
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