Radiology Coding Alert
Vertebroplasty
Utah Subscriber
Answer: Vertebroplasty is a new procedure that is still considered investigational. It consists of an injection of polymethylmethacrylate (PPV) into the vertebral body to provide pain relief and strengthen bones. It has been used successfully in the treatment of aggressive hemangiomas (ICD-9 diagnostic code 228.09), osteolytic or spinal metastases (198.3, secondary malignant neoplasm of brain and spinal cord), and multiple myeloma (203.0), and has been noted for producing fast pain relief with these conditions. Studies are being done to see if similar techniques may be effective for relieving symptoms in patients who suffer from osteoporosis.
There is no national policy for payment of vertebroplasty. CPT codes are being developed but wont be available until at least early 2001, per recent communications from the Society of Cardiovascular Interventional Radiology. All coding and reimbursement must be done through local policy.
Some carriers are suggesting using 22899 (unlisted procedure, spine) to include all services. Other carriers are suggesting 22899 and 76005 (fluoroscopy guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures [epidural, transforaminal epidural, subarachnoid, paravertebral facet joint, paravertebral facet joint nerve or sacroiliac joint], including neurolytic agent destruction). Check with your local carriers for their preferences in billing this procedure.
Source for reader questions is Cindy McMahan, CPC, an independent coding consultant based in Albany, Wis.
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Vertebroplasty
Question:
