Neurosurgery Coding Alert

Question: Our surgeon performed percutaneous lumbosacral vertebroplasty with biopsy, which included two more lumbosacral vertebrae (total of three vertebroplasties). How should I code this encounter?

Montana Subscriber

Answer: You’ll report 22511 (Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; lumbosacral) for the initial vertebroplasty, along with +22512 (… each additional cervicothoracic or lumbosacral vertebral body (List separately in addition to code for primary procedure)) x 2 for the other vertebroplasties.

You would use the same add-on code if your primary vertebroplasty code is 22510 (… cervicothoracic).

Head’s up: Many spinal procedures share the same add-on codes when addressing different spinal levels (cervical, thoracic, lumbar, sacral). For instance, consider 22513 (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; thoracic) and 22514 (… lumbar). Whenever you are adding a spinal level to either of these vertebral augmentation codes, you’ll use +22515 (… each additional thoracic or lumbar vertebral body (List separately in addition to code for primary procedure)) for each additional level.