SI Fusion — Minimally Invasive at GEHA.
How GEHA approaches CPT 27279 (SI Fusion — Minimally Invasive) for prior-authorization review: at last review on 2026-01-01, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-01-01
Policy number
GEHA 2026 FEHBCriteria summary
High-level themes from the GEHA 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 SIJ injections documentation required (typically with ≥75% relief).
Source: GEHA 2026 FEHB - back/spinal surgeries require preauth
See the full GEHA criteria.
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