CPT 27279 · SI Fusion · Tricare
SI Fusion — Minimally Invasive at Tricare.
How Tricare approaches CPT 27279 (SI Fusion — Minimally Invasive) for prior-authorization review: at last review on 2024-09-25, the policy covers this code with prior authorization required.
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Verification pending. This record is awaiting confirmation against the latest policy document — criteria summary may not reflect the current revision.
Criteria summary
High-level themes from the Tricare 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 SI joint injection documentation required (typically with ≥75% relief).
Source: TRICARE Policy Manual 6010.63-M (TPT5), Chapter 4 (Surgery)
See the full Tricare criteria.
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