August 22, 2019

Question:
Is it ever appropriate to bill 22513 with 3 units?

Answer:
CPT 22513 states Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic. It is used to report the first level vertebral augmentation. CPT directs us to use the add-on code, +22515 for “each additional thoracic or lumbar vertebral body”. So your procedure would be reported as 22513 x 1 unit and 22515 x 2 units – not 22513 x 3 units.

*This response is based on the best information available as of 08/22/19.