Full Answer
What is the CPT code for lumbar compression fracture?
You could use a M80.08X- or M80.88X- or the corresponding level code S32.0xxA code 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.
What is the CPT code for lumbar kyphoplasty?
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. I don't believe Medicare is covering the M48.5- code for Kyphoplasty anymore.
What is a spinal compression fracture?
A spinal compression fracture happens when one of the vertebrae of the spine cracks, or fractures. The fracture causes the bone to lose its natural height and collapse, which causes severe pain and compresses the surrounding nerves. fracture?
What is the CPT code for vertebral process fracture?
Several instructional and add-on code parenthetical notes have been added to the CPT manual to clarify the deletion of +22851 and the addition of these new codes. Closed treatment of vertebral process fracture. CPT 22305 (Closed treatment of vertebral process fracture[s]) will be deleted due to low utilization.
How do you code a 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.
What is the CPT code for kyphoplasty lumbar?
Use code 22524 for a lumbar percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, 1 vertebral body, unilateral or bilateral cannulation (eg, kyphoplasty).
Can CPT 22513 and 22514 be billed together?
Percutaneous vertebral augmentation including cavity creation using mechanical device of one vertebral body must be reported with CPT codes 22513 (thoracic), 22514 (lumbar) and 22515 (each additional thoracic or lumbar vertebral body [list separately in addition to code for the primary procedure]).
How do you code vertebroplasty?
The CPT code for sacral vertebroplasty (without cavity creation) is 22511. The CPT codes for sacral vertebral augmentation that include cavity creation are Category III codes 0200T and 0201T.
What is the ICD 10 code for lumbar compression fracture?
000 for Wedge compression fracture of unspecified lumbar vertebra is a medical classification as listed by WHO under the range - Injury, poisoning and certain other consequences of external causes .
Does Medicare cover vertebroplasty?
Coverage will be provided for Percutaneous Vertebroplasty or Percutaneous Vertebral Augmentation when it is determined to be medically necessary because the medical criteria and guidelines shown below are met. Please refer to the member's individual Evidence of Coverage (EOC) for benefits.
What is the ICD 10 code for compression fracture?
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 .
What is procedure code 22514?
22514. PERCUTANEOUS VERTEBRAL AUGMENTATION, INCLUDING CAVITY CREATION (FRACTURE REDUCTION AND BONE BIOPSY INCLUDED WHEN PERFORMED) USING MECHANICAL DEVICE (EG, KYPHOPLASTY), 1 VERTEBRAL BODY, UNILATERAL OR BILATERAL CANNULATION, INCLUSIVE OF ALL IMAGING GUIDANCE; LUMBAR.
What is the ICD 10 code for l2 compression fracture?
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.
What is the difference between kyphoplasty and vertebroplasty?
Vertebroplasty and kyphoplasty are relatively new techniques for the treatment of pain caused by vertebral body compression fractures. Kyphoplasty differs from vertebroplasty in that a balloon is first inflated in the vertebral body to create a cavity into which cement is then injected under lower pressure.
What is procedure code 22512?
Percutaneous Vertebroplasty and Vertebral Augmentation ProceduresCPT® 22512, Under Percutaneous Vertebroplasty and Vertebral Augmentation Procedures. The Current Procedural Terminology (CPT®) code 22512 as maintained by American Medical Association, is a medical procedural code under the range - Percutaneous Vertebroplasty and Vertebral Augmentation Procedures.
What is procedure code 22842?
CPT® Code 22842 in section: Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires)
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.
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
Language quoted from Centers for Medicare and Medicaid Services (CMS), National Coverage Determinations (NCDs) and coverage provisions in interpretive manuals is italicized throughout the policy.
Coverage Guidance
Provisions in this LCD and related coding article only address Vertebral Augmentation for Osteoporotic Vertebral Compression Fracture (VCF). Coverage will remain available for medically necessary procedures for other conditions not included in this LCD.