kyphoplasty

  1. M

    Wiki Kyphoplasty

    UHC is denying payment on 22514 and 22515 Cpt codes billed with M80.08XS as a primary diagnosis. Denial reason is "Invalid primary dx code". Per CMS website the diagnosis code is good. Any ideas?
  2. S

    Wiki Kyphoplasty SNF

    Hi! We have a doctor that wants to do a kyphoplasty in office (which he normally does), but the patient is in a Part A stay at a SNF. Do we just bill straight medicare for this? Or is the SNF going to be responsible for some portion? Thank you!
  3. F

    Wiki Kypho with percutaneous posterior instrumentation?

    Please help! We have a patient that had a lumbar burst fracture. Doctor did a kyphoplasty and added posterior instrumentation percutaneously (pedicle screws, rod). He wanted to bill 22514 and 22842, but I told him we couldn't add the 22842 to the kypho. I felt that 22514-22 would be more...
    • fltbaroque
    • Thread
    • instrumentation kypho kyphoplasty modifier 22 spine coding
    • Replies: 1
    • Forum: Orthopaedics
  4. G

    Wiki Kyphoplasty and Medicare

    We have recently received a Medicare denial for a claim billed out for Kyphoplasty. 22513 x 1 22514 x 1 CCI edit states the family of codes (22513-22515) should only list "One" as the primary code and list the other as add on procedure for the additional level, which we normally do when done...
  5. J

    Wiki Anesthesia during Kyphoplasty

    I have a doctor questioning whether 01936 accurately reflects the work of the anesthesiologist during a Kyphoplasty. So, what code does everyone use for anesthesia during a Kypho? Thanks in advance for your input. Jennifer
  6. K

    Wiki Does SNF have pmt responsibility for 99152?

    Dr did Kyphoplasty on SNF patient in the Office Setting. 99152/99153 were moderate sedation codes billed along with the 22513 for kyphoplasty. Medicare paid 22513...Denied 99152/99153 stating it is responsibilit of SNF. For non-SNF patients, Medicare does pay 99152/99153. Does anybody have any...
  7. D

    Wiki Medicare Reimbursement for Kyphoplasty code 22514

    Our practice has had an issue lately with getting our kyphoplasty (22514) surgeries paid through Medicare. They are getting denied based on medical necessity. We used correct supporting ICD-10 codes but we cannot seem to get Medicare to pay for these surgeries. According to the LCD, this...
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