Anesthesia Coding Alert

Question: Our providers offer kyphoplasty in the office setting. One physician performs the kyphoplasty and another physician or a CRNA provides anesthesia. Is this billable, and can the physician doing the kyphoplasty also be the supervisor for the CRNA?

Codify Subscriber

Answer: CPT^{® includes three codes for kyphoplasty, based on the spinal site and number of vertebral bodies treated:}

• ^{22523 – Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, 1 vertebral body, unilateral or bilateral cannulation (e.g., kyphoplasty); thoracic}
• ^{22524 – … lumbar}
• ^{+22525 – Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, 1 vertebral body, unilateral or bilateral cannulation (e.g., kyphoplasty); each additional thoracic or lumbar vertebral body (List separately in addition to code for primary procedure).}

^{Report these codes as appropriate for the physician performing the kyphoplasty. Report the anesthesia with 01936 (Anesthesia for percutaneous image guided procedures on the spine and spinal cord; therapeutic), whether the provider is an anesthesiologist or CRNA.}

^{The physician cannot perform the procedure and also medically direct or supervise the CRNA at the same time. If a CRNA provides the anesthesia, submit the claim with 01936 and append modifier QZ (CRNA service: without medical direction by a physician). Only report the applicable kyphoplasty code for the physician.}