Radiology Coding Alert

Make this documentation suggestion to your radiologist

CPT Codes does not provide a code for percutaneous vertebroplasty of cervical vertebra(e), but such procedures are possible. Prepare to code for them with these tips.
 
Before CPT added percutaneous vertebroplasty codes 22520-22522 in 2001, most payers recommended that coders report all vertebroplasty procedures using CPT 22899 (Unlisted procedure, spine), says Salt Lake City coder Jennifer Schmutz, CPC.
 
Most payers still recommend this code for cervical vertebroplasties, although you should check with your payer to be sure about individual guidelines.
 
When the interventional radiologist treats "additional" levels in the cervical area, you are justified in reporting 22899. For example, for treatment to levels L4, L5 and C1, your claim should read:
 
• 22521 -- Percutaneous vertebroplasty, one vertebral body, unilateral or bilateral injection; lumbar
 
• +22522 -- ... each additional thoracic or lumbar  vertebral body
 
• 22899.

The radiologist's documentation should explain that 22899 represents an "additional level" in the cervical area.
 
Pointer: When reporting an unlisted-procedure code, include a full description of the procedure so the payer can make an appropriate payment determination. As always for unlisted-procedure codes, include the report to identify the specific effort involved, using 22520-22522 as a reference, Schmutz says.