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Orthopedic Coding Alert

Reader Question:

New Kyphoplasty Codes Don't Guarantee Payment

Published on Sun Feb 08, 2004

Question: I have heard that a new HCPCS code for kyphoplasty was coming this year. What is the code, and how should we report initial and subsequent levels to my Medicare carrier?

Missouri Subscriber Answer: HCPCS 2004 introduced two new kyphoplasty codes, but Medicare did not assign any relative value units (RVUs) to them. You should, therefore, report these codes only to private payers that recognize them:
 
  S2362 - Kyphoplasty, one vertebral body, unilateral or bilateral injection
  S2363 - ... each additional vertebral body (list separately in addition to code for primary procedure). If you're reporting kyphoplasty to Medicare, you should continue to use the code for unlisted spine procedures (22899).
 
In addition, you should submit the operative report to describe the procedure you performed and how many levels you addressed.
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