How To Use CPT Code 22510

CPT 22510 describes the percutaneous vertebroplasty procedure, which involves the surgical repair of a fractured vertebra in the cervicothoracic (neck and upper back) spine. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 22510?

CPT 22510 is used to describe the percutaneous vertebroplasty procedure, which involves the surgical repair of a fractured vertebra in the cervicothoracic spine. This procedure typically includes the injection of bone cement to fuse fracture fragments or bone cement into a cervicothoracic vertebral body lesion. It is commonly performed to treat osteoporotic compression fractures when conservative treatment methods have failed. The procedure is performed under imaging guidance, such as fluoroscopy or computed tomography, to ensure accurate placement of the cement.

2. Official Description

The official description of CPT code 22510 is: ‘Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance cervicothoracic.’

3. Procedure

The percutaneous vertebroplasty procedure involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. The provider performs a percutaneous injection through the skin into the cervicothoracic area of a substance, such as methyl methacrylate, which is a type of acrylic cement.
3. The injection is performed under imaging guidance, either fluoroscopy or computed tomography, to ensure accurate placement of the cement.
4. The provider may inject one or both sides of the vertebra, depending on the specific case.
5. During the procedure, the provider may also perform a bone biopsy by removing bone tissue for laboratory analysis.

4. Qualifying circumstances

CPT 22510 is typically performed on patients with osteoporotic compression fractures in the cervicothoracic spine that have not responded to conservative treatment methods. The procedure is performed by a qualified healthcare professional and may include a bone biopsy for diagnostic purposes. The use of imaging guidance, such as fluoroscopy or computed tomography, is essential to ensure accurate placement of the cement.

5. When to use CPT code 22510

CPT code 22510 should be used when a provider performs percutaneous vertebroplasty on a single vertebral body in the cervicothoracic spine. It is important to note that this code is specific to the cervicothoracic region and should not be used for procedures performed on other areas of the spine. If the procedure involves additional vertebral bodies, an add-on code (such as 22512) should be reported for each additional vertebral body.

6. Documentation requirements

To support a claim for CPT 22510, the provider must document the following information:

• Patient’s diagnosis and indication for the procedure
• Specific details of the procedure performed, including the number of vertebral bodies injected and whether it was a unilateral or bilateral injection
• Imaging guidance used during the procedure (e.g., fluoroscopy or computed tomography)
• Any additional procedures performed during the same session, such as a bone biopsy
• Any complications or adverse events that occurred during or after the procedure
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 22510, it is important to ensure that the procedure was performed on a single vertebral body in the cervicothoracic spine. If the procedure involves additional vertebral bodies, the appropriate add-on code (such as 22512) should be reported for each additional vertebral body. It is also important to document the use of imaging guidance during the procedure and any additional procedures performed, such as a bone biopsy. Providers should follow the specific billing guidelines of their payer to ensure accurate reimbursement.

8. Historical information

CPT 22510 was added to the Current Procedural Terminology system on January 1, 2015. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 22510

There are several similar codes to CPT 22510 that describe percutaneous vertebroplasty and vertebral augmentation procedures. These include:

• CPT 22511: Percutaneous vertebroplasty or vertebral augmentation, each additional vertebral body, cervical/thoracic
• CPT 22512: Percutaneous vertebroplasty or vertebral augmentation, each additional vertebral body, lumbar/sacral

9. Examples

Here are some examples of cases where CPT code 22510 may be billed:

1. A 65-year-old patient with an osteoporotic compression fracture in the cervicothoracic spine undergoes percutaneous vertebroplasty on a single vertebral body.
2. A 70-year-old patient with multiple osteoporotic compression fractures in the cervicothoracic spine undergoes percutaneous vertebroplasty on two vertebral bodies.
3. A 55-year-old patient with a traumatic fracture in the cervicothoracic spine undergoes percutaneous vertebroplasty on a single vertebral body.
4. A 60-year-old patient with a metastatic tumor in the cervicothoracic spine undergoes percutaneous vertebroplasty on a single vertebral body.
5. A 75-year-old patient with severe pain due to an osteoporotic compression fracture in the cervicothoracic spine undergoes percutaneous vertebroplasty on a single vertebral body.