icd 10 code for status post l5 kyphoplasty

Are kyphoplasty procedures being denied due to s codes?

Our Medicare billing rep is saying our kyphoplasty procedures are being denied when used with the compression fracture dx (S codes), that we have to use the osteoporosis or malignant related fractures. This change to the LCD was effective in July. I guess I have been living under a rock! Is this true?? Your wires are crossed.

What is the ICD 10 code for balloon kyphoplasty?

ICD-10-CM1 Diagnosis Codes Diagnosis codes are used by both physicians and hospitals to document the indication for the procedure. Balloon kyphoplasty is performed for pathological fractures of the vertebrae due to osteoporosis and other underlying conditions as labeled.

What is the ICD 10 code for orthopedic aftercare?

Encounter for other orthopedic aftercare. Z47.89 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2020 edition of ICD-10-CM Z47.89 became effective on October 1, 2019. This is the American ICD-10-CM version of Z47.89 - other international versions of ICD-10 Z47.89 may differ.

What does kyphoplasty for pathological fracture mean?

KYPHOPLASTY FOR PATHOLOGICAL FRACTURES DUE TO OSTEOPOROSIS OR MALIGNANCY When patients are admitted for pathological fracture due to osteoporosis or malignancy and kyphoplasty procedures are performed, without any additional procedures during the same inpatient admission, the following DRGs are typically assigned.

What is the ICD-10 code for status post spinal surgery?

Other specified postprocedural states The 2022 edition of ICD-10-CM Z98. 89 became effective on October 1, 2021.

What is the ICD-10 code for lumbar decompression?

26.

What is the ICD-10 code for aftercare following orthopedic surgery?

ICD-10-CM Code for Encounter for other orthopedic aftercare Z47. 89.

What is ICD-10 code for History of compression fracture?

Personal history of (healed) traumatic fracture Z87. 81 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Z87. 81 became effective on October 1, 2021.

What is diagnosis code m961?

1: Postlaminectomy syndrome, not elsewhere classified.

What is the ICD 10 code for failed back surgical syndrome?

In the mean-time, assign M96. 1 Postlaminectomy syndrome, not elsewhere classified for failed back syndrome with documentary evidence of previous laminectomy, discectomy, spinal fusion or foramenotomy. [Effective 20 Jul 2016, ICD-10-AM/ACHI/ACS 9th Ed.]

What is the ICD-10 code for kyphoplasty?

The 2022 edition of ICD-10-CM S22. 080G became effective on October 1, 2021. This is the American ICD-10-CM version of S22. 080G - other international versions of ICD-10 S22.

What is considered orthopedic aftercare?

Z aftercare codes are used in office follow-up situations in which the initial treatment of a disease is complete and the patient requires continued care during the healing or recovery phase or for long-term consequences of the disease.

What is the ICD-10 code for orthopedic?

Encounter for other orthopedic aftercare Z47. 89 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Z47. 89 became effective on October 1, 2021.

How do you code a compression fracture?

If you have no other documentation about the fracture (e.g. whether this is a pathological or a traumatic fracture), then this would code to category M48. 5 - Compression fracture of vertebra NOS, so I would use M48. 56XA for the lumbar site.

How do you code a fracture history of ICD-10?

ICD-10 Code for Personal history of (healed) traumatic fracture- Z87. 81- Codify by AAPC.

What is kyphoplasty procedure?

Like vertebroplasty, kyphoplasty injects special cement into your vertebrae — with the additional step of creating space for the treatment with a balloon-like device (balloon vertebroplasty). Kyphoplasty can restore a damaged vertebra's height and may also relieve pain.

Document 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, §1862 (a) (1) (A) allows coverage and payment for only those services that are considered to be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.

Coverage Guidance

Indications: The principal indications for percutaneous vertebroplasty are painful osteoporotic or osteolytic compression fractures of the thoracic or lumbar vertebrae. In addition, there have been reports of using this procedure for painful hemangiomas or eosinophilic granulomas of the spine.

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 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.