Proper Coding for Cervical Vertebroplasty

Some of the confusion about preparing medical billing is that the CPT does not always provide an exact code for a particular procedure, in this case we’ll use percutaneous vertebroplasty of cervical vertebra(e). It’s not a common procedure but it does occur and until recent years did not have its own designation and even today, some payers aren’t up to date on the proper coding to use to report this procedure.

Before CPT added percutaneous vertebroplasty codes 22520-22522 in 2001, most payers recommended that coders report all vertebroplasty procedures using 22899 (Unlisted procedure, spine).

Most payers still recommend using 22899 code for cervical vertebroplasties, as many carriers aren’t aware of the specialized coding. A good way to alleviate this issue and avoid denials or underpayments is to check with the payer and make sure they know about 22520-22522 before you submit your medical billing claim.

There are also different levels of treatment that when coded correctly and submitted with proper documentation can result in additional claims.

* 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.

Remember, when reporting an unlisted-procedure code, include a full description of the procedure so the payer can make an appropriate payment determination. Include high level documentation to make sure the reason for the unlisted code is as detailed as possible. This will help you get better reimbursements on uncommon procedures.

View all Articles by: Melissa Clark, CCS-P