CPT 27279 · SI Fusion · Humana
SI Fusion — Minimally Invasive at Humana.
How Humana approaches CPT 27279 (SI Fusion — Minimally Invasive) for prior-authorization review: at last review on 2025-12-22, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2025-12-22
Policy number
Spine Surgery (effective 2026-01-01; original effective 2025-04-01)Criteria summary
High-level themes from the Humana 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 intra-articular SIJ injection (anesthetic only) documentation required (typically with ≥75% relief).
Source: Humana Medical Coverage Policy — Spine Surgery (Sacroiliac Joint Fusion subsection)
See the full Humana criteria.
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