2015 icd 9 code for kyphoplasty thoracic

Full Answer

What is the CPT code for kyphoplasty?

For each additional vertebral body treated, report one unit of add-on code 22515. For example, if the surgeon documents kyphoplasty at T10, T11, and L1, report 22513, 22515 x 2. Additional coding rules also mimic those for vertebroplasty: Codes 22513-22515 specify unilateral and bilateral; modifier 50 is not appropriate.

When is kyphoplasty not indicated for back fractures?

Kyphoplasty is not indicated for fractures caused by high-velocity injury or other causes of disabling back pain not due to acute fracture. Kyphoplasty is also not appropriate when the vertebral body fracture is associated with widened pedicles or retropulsion of bone as in a burst fracture.

Does Medicare pay for multiple procedures in kyphoplasty?

MULTIPLE PROCEDURES: The kyphoplasty codes are subject to multiple procedure reduction when billed together with other procedure codes during the same encounter. Medicare pays 100% of the rate for the higher-valued code and pays the lower-valued code at 50% of the rate.

What is kyphoplasty used to treat?

Kyphoplasty is indicated for painful osteoporotic or osteolytic compression fractures of the thoracic or lumbar vertebrae. Kyphoplasty is not indicated for fractures caused by high-velocity injury or other causes of disabling back pain not due to acute fracture.

What is the ICD 10 code for scoliosis?

M41. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.

What is the ICD 9 code for back pain?

ICD-9-CM Diagnosis Code 724.5 : Backache, unspecified.

What is the ICD 9 code for trauma?

2012 ICD-9-CM Diagnosis Code 958.8 : Other early complications of trauma.

WHO ICD-9-CM?

ICD-9-CM is the official system of assigning codes to diagnoses and procedures associated with hospital utilization in the United States. The ICD-9 was used to code and classify mortality data from death certificates until 1999, when use of ICD-10 for mortality coding started.

What is ICD-10 code for thoracic back pain?

ICD-10-CM Code for Pain in thoracic spine M54. 6.

Are ICD-9 codes still used in 2021?

CMS will continue to maintain the ICD-9 code website with the posted files. These are the codes providers (physicians, hospitals, etc.) and suppliers must use when submitting claims to Medicare for payment.

What is an ICD-10 diagnosis code?

Used for medical claim reporting in all healthcare settings, ICD-10-CM is a standardized classification system of diagnosis codes that represent conditions and diseases, related health problems, abnormal findings, signs and symptoms, injuries, external causes of injuries and diseases, and social circumstances.

What is the ICD-10 code for trauma?

Injury, unspecified ICD-10-CM T14. 90XA is grouped within Diagnostic Related Group(s) (MS-DRG v39.0): 913 Traumatic injury with mcc. 914 Traumatic injury without mcc.

What Are diagnosis codes used for?

Diagnosis codes describe an individual's medical condition and are required on claims submitted by health care professionals to third party payers.

How do I find ICD-9 codes?

ICD9Data.com takes the current ICD-9-CM and HCPCS medical billing codes and adds 5.3+ million links between them. Combine that with a Google-powered search engine, drill-down navigation system and instant coding notes and it's easier than ever to quickly find the medical coding information you need.

What is the difference between ICD-9 and ICD-9-CM?

The current ICD used in the United States, the ICD-9, is based on a version that was first discussed in 1975. The United States adapted the ICD-9 as the ICD-9-Clinical Modification or ICD-9-CM. The ICD-9-CM contains more than 15,000 codes for diseases and disorders. The ICD-9-CM is used by government agencies.

What is ICD-9 and ICD-10 difference?

The biggest difference between the two code structures is that ICD-9 had 14,4000 codes, while ICD-10 contains over 69,823. ICD-10 codes consists of three to seven characters, while ICD-9 contained three to five digits.

What is kyphoplasty code 22513?

Select kyphoplasty codes based on the segment of the spine treated. Code 22513 describes the initial vertebral body treated in the thoracic area.

What is a kyphoplasty?

During kyphoplasty (percutaneous vertebral augmentation), the surgeon first creates a working space within the fractured vertebral body, and then places a mechanical device (e.g., an inflatable bone tamp (IBT)) in the enlarged cavity. The bone tamp is inflated to restore height to the damaged vertebral body and then removed.

What is the procedure to fill vertebral fractures?

Percutaneous vertebroplasty is a minimally invasive procedure during which the surgeon injects “bone cement” (methyl methacrylate) into a vertebra (e) to fill vertebral fractures and restore spinal integrity.

What modifier do you use for bone biopsy?

If the physician performs bone biopsy at a level not addressed by the vertebroplasty, you may report the biopsy separately with modifier 59 appended to indicate the separate locations of the two procedures.

What is 22510 or 22512?

If the surgeon treats the final tho racic vertebra (T12) and the first lumbar vertebrae (L1), you would report 22510 or 22512 (not 22510, 225 11). Know What’s Bundled.

General Information

CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

CMS National Coverage Policy

Title XVIII of the Social Security Act, §1833 (e) prohibits Medicare payment for any claim which lacks the necessary information to process the claim.

Article Guidance

The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for Vertebroplasty/Kyphoplasty L33473.

ICD-10-CM Codes that Support Medical Necessity

Use of these codes does not guarantee reimbursement. The patient’s medical record must document that the coverage criteria in this policy have been met.

ICD-10-CM Codes that DO NOT Support Medical Necessity

All other ICD-10 codes not listed under “ICD-10 Codes that Support Medical Necessity” will be denied as not medically necessary.

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.

When reporting vertebroplasty, what is the code selection?

When reporting vertebroplasty, code selection depends on the location and number of vertebral bodies treated. Choose a single “initial level” code based on the location of the first vertebral body treated:

What is 22513 code?

Code 22513 describes the initial vertebral body as treated in the thoracic area . Code 22514 describes the initial vertebral body as treated in the lumbar area. Select only one “initial” level (either 22513 or 22514). For each additional vertebral body treated, beyond the first, report one unit of add-on 22515.

What is a percutaneous vertebral augmentation?

Percutaneous vertebral augmentation (a.k.a., kyphoplasty or balloon-assisted percutaneous vertebroplasty) is a similar to vertebroplasty, but includes the use of an inflatable balloon to “jack up” the damaged vertebra (e) prior to methylmethacrylate injection.

Can you code vertebroplasty and bone biopsy at the same time?

Percutaneous vertebroplasty codes include the two procedures most commonly performed during the same session—imaging guidance and bone biopsy (e.g., Biopsy, bone, trocark or needle; deep (eg, vertebral body, femur)—and therefore you may not code seperately for them at the same level.