CPT 27279 · SI Fusion · CareFirst BCBS
SI Fusion — Minimally Invasive at CareFirst BCBS.
How CareFirst BCBS approaches CPT 27279 (SI Fusion — Minimally Invasive) for prior-authorization review: at last review on 2026-04-26, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-04-26
Policy number
CareFirst-eviCore-MSK-Spine (SI Fusion)Criteria summary
High-level themes from the CareFirst BCBS 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 (27096/G0260) with ≥75% concordant relief documentation required (typically with ≥75% relief).
See the full CareFirst BCBS criteria.
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