The 2015 CPT Code Changes for Vertebroplasty or Kyphoplasty will change the way we code and bill for our physician’s service for Vertebroplasty or Kyphoplasty. Let’s make sure we are aware of these changes that will take effect on January 1st 2015.
2015 CPT Code Changes for Vertebroplasty or Kyphoplasty
You have a 6 New Codes for Vertebroplasty or Kyphoplasty Procedure
22510 – Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic
22511 – … lumbosacral
+22512 – … each additional cervicothoracic or lumbosacral vertebral body (List separately in addition to code for primary procedure)
*** (Use 22512 in conjunction with 22510, 22511)
(Do not report 22510, 22511, 22512 in conjunction with 20225, 22310, 22325, 22327 when performed at the same level as 22510, 22511, 22512)
22513 – Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (e.g., kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic
22514 – … lumbar
+22515 – … each additional thoracic or lumbar vertebral body (List separately in addition to code for primary procedure).
*** (Use 22515 in conjunction with 22513, 22514)
(Do not report 22513, 22514, 22515 in conjunction with 20225, 22310, 22315, 22325, 22327 when performed at the same level as 22513, 22514,22515)
You must remember that:
1. These codes will replace your Codes 22520 to 22525
2. These codes are billed and coded unilateral or bilateral. Modifier 50 (Bilateral), Modifier LT, RT (Left and Right) will apply.
3. Modifier 51 does not apply to your “add-on” codes +22512, +22515
4. All these 6 codes are inclusive with “moderate sedation” represented by a red “bullseye”, that means, you cannot bill separately for moderate sedation.
5. Code 22510 with “cervicothoracic” means you can now bill the cervical region rather than choosing the unlisted code in 2014 Code 22899 – “unlisted procedure, spine”.
6. Since the new codes are “inclusive of all imaging guidance” – in 2015, you can no longer bill the radiological codes for guidance –
Forget these 2 radiological codes in 2015!
72291 – Radiological supervision and interpretation, percutaneous vertebroplasty, vertebral augmentation, or sacral augmentation (sacroplasty), including cavity creation, per vertebral body or sacrum; under fluoroscopic guidance
72292 – … under CT guidance.
References: CPT Changes 2015, CPT Code Book 2015
According to the Guidelines of the American Medical Association (who owns CPT):
“Codes 22510, 22511, 22512, 22513, 22514, 22515 describe procedures for percutaneous vertebral augmentation that include vertebroplasty of the cervical, thoracic, lumbar, and sacral spine and vertebral augmentation of the thoracic and lumbar spine.”
“For the purposes of reporting 22510, 22511, 22512, 22513, 22514, 22515, “vertebroplasty” is the process of injecting a material (cement) into the vertebral body to reinforce the structure of the body using image guidance. “Vertebral augmentation” is the process of cavity creation followed by the injection of the material (cement) under image guidance. For 0200T and 0201T, “sacral augmentation (sacroplasty)” refers to the creation of a cavity within a sacral vertebral body followed by injection of a material to fill that cavity.”
“The procedure codes are inclusive of bone biopsy, when performed, and imaging guidance necessary to perform the procedure. Use one primary procedure code and an add-on code for additional levels. When treating the sacrum, sacral procedures are reported only once per encounter.”
These codes have been changed in 2017!
Read the changes here 2017 Billing for Moderate Conscious Sedation with Surgery Procedure Huge Changes in 2017
Reference Sourcec: CPT ©2016 American Medical Association
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