Orthopedic Coding Alert

You've read the coding basics--but can you select the right code?

If you don't know which codes to report for kyphoplasty and vertebroplasty, you could be up a creek if your surgeon turns in an op note citing one of these surgical procedures.

The differences between vertebroplasty and kyphoplasty may be subtle, but the coding options are quite different. Now that you-ve studied the nuances between the procedures with our guest column and article in this special issue, determine whether you can select the right code in our quick quiz below. What Would You Choose for a Single Lumbar Vertebral Body Kyphoplasty? Question: Which of the following codes would you use to report a kyphoplasty procedure that an orthopedic surgeon performs on a single lumbar vertebral body of a patient with osteoporosis? A. 22523
B. 22524
C. S2362
D. All of the above
E. None of the above Hint: Use 1 of CPT's New Codes for This Procedure Answer: CPT created three kyphoplasty procedure codes this year. For lumbar kyphoplasty on a single level, you should report one unit of 22524 (Percutaneous vertebral augmentation, including cavity creation [fracture reduction and bone biopsy included when performed] using mechanical device, one vertebral body, unilateral or bilateral cannulation [e.g., kyphoplasty]; lumbar). Therefore, the answer to our question is -B.-

If, however, the orthopedic surgeon had performed a thoracic kyphoplasty, you should have instead reported 22523 (Percutaneous vertebral augmentation, including cavity creation [fracture reduction and bone biopsy included when performed] using mechanical device, one vertebral body, unilateral or bilateral cannulation [e.g., kyphoplasty]; thoracic).

Code S2362 (Kyphoplasty, one vertebral body, unilateral or bilateral injection) was one of the two HCPCS codes that coders had to use for kyphoplasty procedures prior to Jan. 1, 2006. This code is incorrect because it is now outdated.