Practice Management Alert

Stop reporting imaging guidance separately.

You’ll be reporting kyphoplasty and percutaneous vertebroplasty services differently in 2015, thanks to CPT® 2015 code changes — and one new code will help you avoid unlisted code use. 

Get to know the changes and what they’ll mean to your practice come January 1. 

Focus on Anatomical Area

You’ll have six new codes that will represent the services based on the number of vertebral bodies treated and the spinal area. Note that each code will continue to represent both unilateral and bilateral injections: 

• 22510 – Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic 
  
• 22511 – … lumbosacral 
  
• +22512 – … each additional cervicothoracic or lumbosacral vertebral body (List separately in addition to code for primary procedure) 
  
• 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 
  
• 22514 – … lumbar 
  
• +22515 – … each additional thoracic or lumbar vertebral body (List separately in addition to code for primary procedure). 
  

“It’s important to see that the new vertebroplasty code, 22510, also includes the cervical spine region,” says Marvel J. Hammer, RN, CPC, CCS-P, PCS, ACS-PM, CHCO, of MJH Consulting in Denver, Co. “If a provider performs a cervical vertebroplasty in 2014, you can only report it with 22899 (Unlisted procedure, spine). It will be good that pain management providers will be able to report the cervical procedure with the new 22510 code.” 

Skip Imaging Codes

These codes will replace your current options, 22520-22525. The biggest change is the addition of “inclusive of all imaging guidance” to the descriptors. Each of the new codes also includes the “bulls-eye” symbol designation, which means the associated RVUs and service include moderate sedation. This is new for kyphoplasty in 2015. The 2014 codes (22523-22525) did not include moderate sedation, so you could bill it separately. 

Because of the updated descriptors, the associated radiology codes for guidance will be deleted. You’ll no longer be able to report the following codes as part of your vertebroplasty or kyphoplasty claim: 

• 72291 – Radiological supervision and interpretation, percutaneous vertebroplasty, vertebral augmentation, or sacral augmentation (sacroplasty), including cavity creation, per vertebral body or sacrum; under fluoroscopic guidance 
  
• 72292 – … under CT guidance.