Radiology Coding Alert

Question: Public aid will not pay our radiologist for CPT 22521 , saying they only pay a surgeon, assistant surgeon, and an anesthesiologist for this procedure. Do I need to change how I report this service?


Illinois Subscriber

Answer: You should continue to report 22521 (Percutaneous vertebroplasty, one vertebral body, unilateral or bilateral injection; lumbar) if that code most accurately describes your radiologist's service.

You made need to change the type-of-service (TOS) or place-of-service code, however, from radiology to surgery. And check to see if a physician registered as an "interventional radiologist" is covered, even if a "radiologist" isn't.

Note: If the public-aid determination is based only on physician specialty, your physicians may want to take this up with your state medical society, the state radiology society, or a national organization such as the SIR or the ACR.