Wiki Kyphoplasty

[Pat Liebl]

My doctor did a Bilateral T12, L1 Kyphoplasty We billed cpt 22513 For the Thoracic and 22514 for the Lumbar. 22514 got denied for not being covered. I am wondering if we should have just billed the add on code 22515 which is for Thoracic or Lumbar instead 22514 which was for the lumbar. Does anyone know the correct way to bill.

 

[emcee101]

How ironic, I just finished the Healthcare Business Monthly March issue and there was an entire article in there dedicated to coding for vertebroplassty and kyphoplasty. You are correct with your logic to bill 22513 and then the add-on code 22515, even though your doctor worked on lumbar and thoracic vertebrae. The coder is supposed to select the initial level as the primary code, and then use the add on code for all additional vertebrae regardless of spinal level.

 

[Pat Liebl]

Thank YOu so much