# Veptr



## nyyankees (May 15, 2009)

Has anyone ever hrard of a VEPTR device to treat scoliosis? My doc put down instrumentation code (which was an add-oncode) by itself. Never heard of it.

Any ifno would be appreciated...


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## RebeccaWoodward* (May 15, 2009)

Yes...vertical expandable prosthetic titanium rib....But, there isn't a CPT code for this.  At least...not to my knowledge.


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## nyyankees (May 15, 2009)

THANK YOU. I GUESS I'LL USE AN UNLISTED CODE.....


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## lzcoder (May 17, 2009)

I am in San Antonio, Tx where VEPTR device was first implanted.  We have been using the unlisted code with various charges.  If you need more info let me know.


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## nyyankees (May 18, 2009)

lzcoder said:


> I am in San Antonio, Tx where VEPTR device was first implanted.  We have been using the unlisted code with various charges.  If you need more info let me know.



Thank you...I was thinking of using unlisted code 22899 (unlisted - spine) but am not sure what CPT/RVU to compare?

Seems like a bone graft/instrumentation combo...not sure though.

Thanks...


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## lzcoder (May 18, 2009)

We've been using 32999 and getting reimbursed.  Just make sure you submit Operative Reports with your claim. Most insurances now reimbursement without incident but of course some do require appeals.


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## nyyankees (May 26, 2009)

lzcoder said:


> We've been using 32999 and getting reimbursed.  Just make sure you submit Operative Reports with your claim. Most insurances now reimbursement without incident but of course some do require appeals.



What CPT code would you use to compare RVU's? Do you have a hard time getting these paid?

Thanks...


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## FTessaBartels (May 26, 2009)

*Depends*

For *INITIAL surgery *(first implanting the VEPTR device)
Rib-to-rib  -or-  Rib-to-pelvis -- CPT 22189 Unlisted thoracic (price based on 22840)

Rib-to-spine -- CPT 22899 Unlisted spinal (price based on 22842)

*IF performed* - also code 21600 Excision of rib, partial

For *BILATERAL* procedure, bill on two lines with RT and 59/LT modifiers 


*EXPANSION surgery*
CPT 21899 Unlisted procedure thorax (price based on 22849)

*EXCHANGE* surgery (without new segments)
Use unlisted codes as for initial placement (price based on 22849)

*EXCHANGE surgery *- rib-to-rib changed for rib-to-spine OR rib-to-pelvis
CPT 22899 unlisted procedure, spine (price based on 22849 -22)

*MODIFIERS* used
-62 if general or thoracic surgeon is performing part of procedure
-RT and -59/LT if bilateral

I got this from our Pediatric Ortho coder. Hope that helps. 

F Tessa Bartels, CPC, CEMC


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## nyyankees (May 26, 2009)

THANK YOU TESSA- UNFORTUNATELY MY DR DOESN'T WANT TO USE THE UNLISTED CODE....NONE OF MY DR'S DO...DON'T KNOW WHY I EVEN MENTIONED IT!!!


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## FTessaBartels (May 26, 2009)

*You have a battle*

I feel your pain - our ortho docs HATE unlisted codes!

Still, There is NO code for this procedure. You can't use the spinal instrumentation codes because:
1) they're not attaching anything to the spine (most of the time)
and
2) the instrumentation codes are add-ons and you need to have the spinal fusion code first.

Maybe you should try to get some printed info from Christus Santa Rosa Orthopedics (where the VEPTR procedure was developed) and other leading instutions on this. That's what we did when we started doing it. 

Good luck.

F Tessa Bartels, CPC, CEMC


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## kfissler@medkoder.com (Apr 7, 2016)

lzcoder said:


> I am in San Antonio, Tx where VEPTR device was first implanted.  We have been using the unlisted code with various charges.  If you need more info let me know.



Hello. I code for a Children's hospital where they do the VEPTR placement. I know that it has to be billed with an unlisted code, but I'm interested to know what you use for comparison codes. I have been using spinal instrumentation codes (22843, 22844) for compare codes, but the RVU's and price doesn't seem to be appropriate for this procedure.

Thanks in advance,
Kristie


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