CPT Code 22512

CPT code 22512 is for an additional injection during a vertebroplasty procedure, which is a treatment for spinal fractures.

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What is CPT Code 22512

CPT code 22512 is used for an additional injection during a vertebroplasty procedure. This code is specifically for when more than one vertebra is treated with the injection of bone cement to stabilize fractures or other issues in the spine.

Does CPT 22512 Need a Modifier?

For CPT code 22512 (Vertebroplasty, additional injection), the following modifiers may be applicable:

1. Modifier 50 - Bilateral Procedure: Used if the procedure is performed on both sides of the body.

2. Modifier 51 - Multiple Procedures: Applied when multiple procedures are performed during the same session.

3. Modifier 59 - Distinct Procedural Service: Indicates that the procedure is distinct or independent from other services performed on the same day.

4. Modifier 76 - Repeat Procedure by Same Physician: Used if the same procedure is repeated by the same physician on the same day.

5. Modifier 77 - Repeat Procedure by Another Physician: Applied if the procedure is repeated by a different physician on the same day.

6. Modifier 78 - Unplanned Return to the Operating/Procedure Room: Used if the patient returns to the operating room for a related procedure during the postoperative period.

7. Modifier 79 - Unrelated Procedure or Service by the Same Physician: Indicates that the procedure is unrelated to the original procedure and performed by the same physician during the postoperative period.

8. Modifier LT - Left Side: Used to specify that the procedure was performed on the left side of the body.

9. Modifier RT - Right Side: Used to specify that the procedure was performed on the right side of the body.

Each modifier serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.

CPT Code 22512 Medicare Reimbursement

Medicare Reimbursement for CPT Code 22512: Vertebroplasty Additional Injection

CPT code 22512 pertains to the additional injection(s) for vertebroplasty, a procedure used to stabilize compression fractures in the spine. Medicare does provide reimbursement for this code, but the amount can vary based on several factors, including geographic location, the specific Medicare Administrative Contractor (MAC), and the setting in which the procedure is performed (e.g., hospital outpatient department, ambulatory surgical center).

As of the most recent data, the national average reimbursement rate for CPT code 22512 under the Medicare Physician Fee Schedule (MPFS) is approximately $200. However, this figure is subject to change and should be verified with the latest fee schedule updates and local MAC guidelines.

For the most accurate and up-to-date reimbursement information, healthcare providers should consult the Medicare Physician Fee Schedule Look-Up Tool or contact their local MAC.

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