The Centers for Medicare and Medicaid Services (CMS) recently created two new C codes for the reporting of kyphoplasty. Kyphoplasty is a new surgical procedure created for the treatment of vertebral compression fractures. This procedure involves the creation of a void with partial restoration of vertebral body height by the insertion of an inflatable balloon tamp percutaneously into a vertebral body. Following this procedure bone cement is introduced under low pressure to fill the cavity in the vertebral body.
A single level vertebral kyphoplasty procedure may involve either unilateral or bilateral vertebral body void creation and injection of cement. Kyphoplasty should be billed as a complete procedure by the hospital, coding only one unit of the appropriate C-code for each vertebral body treated. Hospitals may bill for the radiological supervision and interpretation service provided during the kyphoplasty, in addition to the kyphoplasty C-code(s).
The table below provides a listing of two new codes reported for kyphoplasty under the OPPS.
|HCPCS||Effective Date||SI||APC||Short Descriptor||Long Descriptor||Payment Rate||Minimum Unadjusted Co-payment|
|C9718||01/01/05||T||0051||Kyphoplasty, first vertebra||Kyphoplasty, one vertebral body, unilateral or bilateral injection||$2,043.45||$408.69|
|C9719||01/01/05||T||0051||Kyphoplasty, each addl||Kyphoplasty, one vertebral body, unilateral or bilateral injection, each additional vertebral body||$2,043.45||$408.69|