CPT® includes three codes to describe kyphoplasty, which mirror the vertebroplasty codes: 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).
Other relative contraindications include a collapse of a vertebra to less than 1/3 of the original height or significant neurologic symptoms related to the compression of the vertebrae. Kyphoplasty is indicated for painful osteoporotic or osteolytic compression fractures of the thoracic or lumbar vertebrae.
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. Additional coding rules mimic those we applied, above, for vertebroplasty:
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.
Other specified postprocedural states The 2022 edition of ICD-10-CM Z98. 89 became effective on October 1, 2021.
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.
Other specified postprocedural statesICD-10 code Z98. 89 for Other specified postprocedural states is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
26.
000A for Wedge compression fracture of unspecified thoracic vertebra, initial encounter for closed fracture is a medical classification as listed by WHO under the range - Injury, poisoning and certain other consequences of external causes .
ICD-10 Code for Personal history of (healed) traumatic fracture- Z87. 81- Codify by AAPC.
ICD-10 Code for Atherosclerotic heart disease of native coronary artery without angina pectoris- I25. 10- Codify by AAPC.
Postlaminectomy syndrome, not elsewhere classified M96. 1 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 M96. 1 became effective on October 1, 2021.
ICD-10-CM Code for Postlaminectomy syndrome, not elsewhere classified M96. 1.
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.]
The work of placing the bone graft is included in the arthrodesis/fusion codes. All spinal bone graft codes are add-on codes....3. Choose the appropriate add-on bone graft code with fusion.TypeMorselizedStructuralAllograft (donor bone)+20930+20931Autograft (patient's bone)+20936, +20937+20938Dec 9, 2021
ICD-10-PCS will be the official system of assigning codes to procedures associated with hospital utilization in the United States. ICD-10-PCS codes will support data collection, payment and electronic health records. ICD-10-PCS is a medical classification coding system for procedural codes.
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
Title XVIII of the Social Security Act, §1833 (e) prohibits Medicare payment for any claim which lacks the necessary information to process the claim.
The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for Vertebroplasty/Kyphoplasty L33473.
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.
All other ICD-10 codes not listed under “ICD-10 Codes that Support Medical Necessity” will be denied as not medically necessary.
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.
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, 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:
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.
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.
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
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.
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.