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Basics about Vertebroplasty CPT code 22510-22512

Percutaneous vertebroplasty is performed to stabilize a compression fracture caused by osteoporosis of the spine. It may also be used to treat aggressive hemangiomas of the vertebral body and for palliative treatment of pathological fractures caused by benign or malignant neoplasms of the spine. It is a procedure that replaces the vertebral body marrow with cement. CPT code 22510-22512 is used to report Vertebroplasty.

A bone needle is placed into the vertebral body from a transpedicular or lateral approach. A biopsy may be obtained (bundled). A mixture of polymethylmethacrylate (PMMA) bone cement and contrast medium, such as sterile barium or tungsten powder, is injected into the vertebral body.

Vertebroplasty is different from kyphoplasty. With kyphoplasty, a cavity is created in the vertebral body for subsequent placement of bone cement. This is referred to as augmentation, which is not done with vertebroplasty.

Description of CPT code 22510, 22511 & 22512

Percutaneous vertebroplasty is a minimally invasive, image-guided procedure performed by a one- or two-sided injection of a vertebral body. A local anesthetic is administered. A needle is guided into the fractured vertebra under imaging guidance through a small puncture in the patient’s skin. Sterile biomaterial such as methyl methacrylate is injected from one or both sides into the damaged vertebral body and acts as a bone cement to reinforce the fractured or collapsed vertebra. The procedure does not restore the original shape to the vertebra, but it does stabilize the bone, preventing further fracture or collapse. Following the procedure, the patient may experience significant, almost immediate pain relief. These codes include a vertebral bone biopsy, if performed, during the same operative session. CPT code 22510 is reported for percutaneous vertebroplasty of one vertebral body at the cervicothoracic level; 22511 for percutaneous vertebroplasty of one vertebral body at the lumbosacral level; and CPT code 22512 for each additional cervicothoracic or lumbosacral vertebral body treated. All imaging guidance is included in these procedures.

22510 : Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic

22511 : Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; lumbosacral

+22512 : Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; each additional cervicothoracic or lumbosacral vertebral body (List separately in addition to code for primary procedure)

Supervision and Interpretation (S&I) are bundled in CPT code 22510, 22511 & 22512.

Do and Don’t with Verterboplasty CPT codes

CPT code 22510 includes vertebroplasty of the cervical vertebral bodies as well as thoracic.
CPT code 22511 includes vertebroplasty of the sacrum as well as the lumbar vertebral bodies.
Do not get confuse with “Kyphoplasty” of scarum, code 0200T or 0201T are used for for sacrum kyphoplasty. Use these codes only for sacral augmentation with balloon or acruplasty and cement injection. Also cavity creation is required for coding these codes.
While coding vertebroplasty of both thoracic and lumbar vertebrae, we should only report one initial level code and an “additional” level code for the another level. For example, if vertebroplasty is performed on both thoracic and lumbar, the we should report the initial level code 22510 followed by cpt code 22512.
All C, T, L, and S vertebroplasties are described as being in a single “family” of codes. Only one “initial” code is submitted per “family”. Any other levels treated are considered additional vertebroplasties.
Guidance codes are bundled with vertebroplasty, kyphoplasty and sacroplasty.
Do not code deep bone biopsy of the same vertebrae treated by vertebroplasty, kyphoplasty, or sacroplasty, as it is bundled into the payment. Biopsy exam at a completely separate bone site via separate access should be separately billed.
Do not use limited CT scan code 76380 for follow-up CT imaging post vertebroplasty, kyphoplasty, or sacroplasty as imaging is bundled.