Radiology Coding Alert

Question: Should I use 22520-+22522 to report percutaneous vertebroplasty that involves inserting an inflatable balloon?

Texas Subscriber

Answer: The use of the balloon suggests the procedure is kyphoplasty rather than vertebroplasty. So you should look to the following codes:

• 22523 -- Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, 1 vertebral body, unilateral or bilateral cannulation (e.g., kyphoplasty); thoracic
• 22524 -- ... lumbar
• +22525 -- ... each additional thoracic or lumbar vertebral body (List separately in addition to code for primary procedure).

In both kyphoplasty and vertebroplasty (22520-+22522, Percutaneous vertebroplasty ...) the physician introduces bone cement into the vertebral bone, repairing spinal fractures, filling any spaces, and increasing stability.

If the physician inserts an inflatable balloon into the vertebral space to augment vertebral height, look to the kyphoplasty codes -- even if the physician refers to it as balloon-assisted vertebroplasty.

Remember: Report radiological supervision and interpretation for both vertebroplasty and kyphoplasty using 72291-72292 (Radiological supervision and interpretation, percutaneous vertebroplasty, vertebral augmentation, or sacral augmentation [sacroplasty], including cavity creation, per vertebral body or sacrum ...).