M46.1: Sacroiliitis, not elsewhere classified

M46.1, sacroiliitis, not elsewhere classified, is listed as a covered diagnosis in 11 Medicare billing and coding articles that apply to 24 HCPCS Level II codes, including G0260 (Injection procedure for sacroiliac joint; provision of…), G0283 (Electrical stimulation (unattended), to one or more areas…), E0783 (Infusion pump system, implantable, programmable (includes…). 4 of these codes have a 2026 DMEPOS fee schedule amount; E0783 pays $9,917.33 to $11,667.45 (NU) depending on the state. The articles come from 5 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.

HCPCS Level II codes with M46.1 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
G0260Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrographySpecial coverage instructions apply—5
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of careCarrier judgment—4
E0783Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)Special coverage instructions apply$9,917.33–$11,667.45 (NU)1
E0786Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)Special coverage instructions apply$10,969.75–$11,380.88 (NU)1
E0782Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)Special coverage instructions apply$5,200.92–$6,118.73 (NU)1
E0785Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacementSpecial coverage instructions apply$572.38–$673.39 (KF)1
J7999Compounded drug, not otherwise classifiedSpecial coverage instructions apply—1
J2278Injection, ziconotide, 1 microgramSpecial coverage instructions apply—1
J2274Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mgSpecial coverage instructions apply—1
A4220Refill kit for implantable infusion pumpSpecial coverage instructions apply—1
J9200Injection, floxuridine, 500 mgSpecial coverage instructions apply—1
G0281Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of careCarrier judgment—2
G0329Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of careCarrier judgment—2
A9585Injection, gadobutrol, 0.1 mlCarrier judgment—1
Q9953Injection, iron-based magnetic resonance contrast agent, per mlSpecial coverage instructions apply—1
G0152Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutesCarrier judgment—1
G0158Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutesCarrier judgment—1
G0160Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutesCarrier judgment—1
G2169Services performed by an occupational therapist assistant in the home health setting in the delivery of a safe and effective occupational therapy maintenance program, each 15 minutesCarrier judgment—1
G2010Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointmentCarrier judgment—1
G2250Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointmentCarrier judgment—1
G2251Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of clinical discussionCarrier judgment—1
G0151Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutesCarrier judgment—1
G0282Electrical stimulation, (unattended), to one or more areas, for wound care other than described in g0281Non-covered by MedicareNot covered1

Medicare policy articles listing M46.1

A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.

Other M46 diagnoses (Other inflammatory spondylopathies)

Frequently asked questions

Does Medicare cover M46.1 (Sacroiliitis, not elsewhere classified)?

Medicare covers items and services, not diagnoses. 11 Medicare billing and coding articles list M46.1 as a covered diagnosis for 24 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.

Which HCPCS codes can be billed with ICD-10 M46.1?

The Level II codes from the policies most specific to this diagnosis are G0260 (Injection procedure for sacroiliac joint; provision of…, 5 articles); G0283 (Electrical stimulation (unattended), to one or more areas…, 4 articles); E0783 (Infusion pump system, implantable, programmable (includes…, 1 article); E0786 (Implantable programmable infusion pump, replacement…, 1 article); E0782 (Infusion pump, implantable, non-programmable (includes all…, 1 article). Code choice depends on the item supplied; check each code's descriptor.

What does Medicare pay for equipment billed with M46.1?

Under the 2026 DMEPOS fee schedule (non-rural state fees): E0783 $9,917.33 to $11,667.45 (NU); E0786 $10,969.75 to $11,380.88 (NU); E0782 $5,200.92 to $6,118.73 (NU); E0785 $572.38 to $673.39 (KF). Medicare pays 80% of the allowed amount after the Part B deductible.

Which Medicare policy articles list M46.1?

A59154 (Billing and Coding: Sacroiliac Joint Injections and Procedures); A59192 (Billing and Coding: Sacroiliac Joint Injections and Procedures); A59233 (Billing and Coding: Sacroiliac Joint Injections and Procedures), and 8 more articles.

What is ICD-10-CM code M46.1?

M46.1 is the ICD-10-CM code for sacroiliitis, not elsewhere classified, in category M46 (Other inflammatory spondylopathies), chapter 13: Diseases of the musculoskeletal system and connective tissue.

Next steps

Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.

Chapter 13: Diseases of the musculoskeletal system and connective tissue · All diagnoses · HCPCS lookup