Anesthesia Coding Alert

Question: One of our physicians performed a vertebroplasty in the office while another provider administered general anesthesia. How should I report the anesthesia for this in an office setting?


Ohio Subscriber

Answer: Vertebroplasty is usually a percutaneous procedure coded with the appropriate choice from 22520 (Percutaneous vertebroplasty, one vertebral body, unilateral or bilateral injection; thoracic), 22521 (- lumbar) or +22522 (- each additional thoracic or lumbar vertebral body [list separately in addition to code for primary procedure]).

The corresponding anesthesia code is 01905 (Anesthesia for myelography, diskography, vertebroplasty) with five base units. 

Because most patients don't require anesthesia during vertebroplasty, some coders recommend appending modifier 23 (Unusual anesthesia) to the anesthesia code. Other coders say including a letter of medical necessity and documentation supporting the need for anesthesia is sufficient. Check with your carrier to verify whether modifier 23 is necessary.

Report place of service 11 since the doctor performed the procedure in the office.