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).
Kyphosis. Kyphosis deformity of spine. Kyphosis, acquired. Kyphosis, idiopathic. ICD-10-CM M40.209 is grouped within Diagnostic Related Group (s) (MS-DRG v37.0): 456 Spinal fusion except cervical with spinal curvature or malignancy or infection or extensive fusions with mcc.
Unspecified fracture of T11-T12 vertebra, initial encounter for closed fracture. This is the American ICD-10-CM version of S22.089A - other international versions of ICD-10 S22.089A may differ.
2018/2019 ICD-10-CM Diagnosis Code Z47.89. 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.
080D for Wedge compression fracture of T11-T12 vertebra, subsequent encounter for fracture with routine healing is a medical classification as listed by WHO under the range - Injury, poisoning and certain other consequences of external causes .
A T12 or L1 compression fracture most commonly happens as a wedge fracture, which occurs when the front part of the vertebra collapses and the back doesn't, making the bone look like a wedge. Osteoporosis, which causes decreased bone density, is a common risk factor for compression fractures.
kyphoplasty: a minimally invasive procedure used to treat vertebral compression fractures by inflating a balloon to restore bone height then injecting bone cement into the vertebral body.
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.
twelfth thoracic vertebraThe T12, or twelfth thoracic vertebra is the largest of all your thoracic vertebrae, and is the lowermost in the back. It's designed to bear the weight of your spine, and is the strongest of all vertebrae in the region, but it's also the most prone to injuries from stress.
The T12 vertebra sits right above the lumbar spinal column. It is the largest and most inferior of the thoracic spinal vertebrae. The T12 vertebrae location is between the T11 vertebra and the first lumbar vertebra, L1, in the trunk region.
Since there is no regular CPT code for the procedure being performed at a cervical level, use the unlisted CPT code 22899 for a cervical kyphoplasty procedure.
How is a compression fracture treated?Pain medicine to relieve your back pain.Bed rest for a short time, followed by limited activity while your bones heal.Wearing a back brace.Physical therapy to help you move better and strengthen the muscles around your spine.
The goals of a kyphoplasty surgical procedure are designed to stop the pain caused by a spinal fracture, to stabilize the bone, and to restore some or all of the lost vertebral body height due to the compression fracture.
In ICD-10-CM, codes for compression and pathologic fractures of the spine (not due to trauma) are located in Chapter 13, Diseases of the Musculoskeletal System and Connective Tissue. Category M48. 5-, Collapsed vertebra, not elsewhere classifiable is used for vertebrae fracture where no cause is listed.
Wedge compression fracture of second lumbar vertebra, initial encounter for closed fracture. S32. 020A 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 S32.
03.
In most cases, compression fractures caused by injuries heal in about 8 weeks. But it can take longer if surgery is needed.
This is the most severe type of spinal fracture because it can result in compressing the nerves, leading to neurological complications.
All the patients with L1 fractures and 70.9% of the patients with T12 fractures were able to walk independently with or without walking aids, but unfortunately, all the patients with T10 and T11 fractures didn't regain the walking ability even 12 months after surgery.
Spine compression fractures are serious, and they can cause painful or debilitating symptoms that interfere with your quality of life. Fortunately, treatment can help repair the damage and relieve symptoms.
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 2021 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.