Wiki Kyphoplasty-I work for

[TrishSander]

Hello,

I work for a billing company and we are now billing for a pain management doctor who does kyphoplasty. Depending on the situation we are using codes 22523, 22524 and 22525. Can someone tell me how these codes are to be billed with multiple units? For example: Medicare usually likes to see codes listed separately instead of in units, but no matter how we bill it, whether in units or separate lines they are requesting medical necessity documentation. Should we be billing in separate lines with a 76 modifier or a 59 modifier? I just want to make sure we are billing these correctly.

Thanks for you help.

 

[donnajrichmond]

Hello,

I work for a billing company and we are now billing for a pain management doctor who does kyphoplasty. Depending on the situation we are using codes 22523, 22524 and 22525. Can someone tell me how these codes are to be billed with multiple units? For example: Medicare usually likes to see codes listed separately instead of in units, but no matter how we bill it, whether in units or separate lines they are requesting medical necessity documentation. Should we be billing in separate lines with a 76 modifier or a 59 modifier? I just want to make sure we are billing these correctly.

Thanks for you help.

22523 and 22524 cannot be coded with multiple units, modifier 50, or any other multiple way - those 2 codes are for the initial level treated.
Theoretically 22525 can be coded, but some of the LCDs state that they would not expect to see more than 2 levels treated at a session. If your Medicare contractor is one of those, then you'll probably get denied for more than one 22525 and have to appeal to show medical necessity for the 3rd + levels.