Anesthesia Coding Alert

Question: Is kyphoplasty considered an open or a closed procedure? What are the surgical and anesthesia codes for it?

Colorado Subscriber

Answer: CPT does not include a code for kyphoplasty, so the surgeon should report 22899 (Unlisted procedure, spine). This crosses to anesthesia code 00640 (Anesthesia for manipulation of the spine or for closed procedures on the cervical, thoracic or lumbar spine).

Several alternative anesthesia codes may apply (including 00600, Anesthesia for procedures on cervical spine and cord; not otherwise specified; and 00620, Anesthesia for procedures on thoracic spine and cord; not otherwise specified), so check your carrier's local policy to determine which is your best option.

Kyphoplasty is a minimally invasive, closed procedure that surgeons perform to treat vertebral compression fractures. The physician might administer either local or general anesthesia for the procedure.

HCPCS 2004 included two new kyphoplasty codes (S2362, Kyphoplasty, one vertebral body, unilateral or bilateral injection; and S2363, ... each additional vertebral body [list separately in addition to code for primary procedure]). However, you can only report them to private payers who accept them because Medicare did not assign the codes relative value units. Continue to submit 22899 to Medicare, but check with other carriers to determine which codes they accept.