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2025 CPT code 22514

Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (e.g., kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar.

This code is for lumbar vertebrae only. Use add-on code 22515 for additional vertebral bodies. Bone biopsy, when performed, is included. Imaging guidance is included. Modifier 62 may be used if two surgeons perform distinct parts of the procedure.

Modifiers such as 22 (increased procedural services), 51 (multiple procedures), 59 (distinct procedural service), 62 (two surgeons), 76 (repeat procedure by same physician), and 77 (repeat procedure by another physician) may be applicable.

Medical necessity must be established by documenting the patient's pain, functional limitations, and failure of conservative treatment. The documentation should also support the specific vertebral level treated.

The physician prepares the patient and administers anesthesia. Using imaging guidance, they insert a needle and balloon into the vertebra. The balloon is inflated to restore height, and bone cement is injected. A bone biopsy may also be performed.

IMPORTANT:For additional vertebral bodies, use add-on code 22515. For thoracic vertebral augmentation, see 22513. For thermal destruction of intraosseous basivertebral nerve, see 64628, 64629. Subsequent replacement of cast, splint, or strapping (29000-29750) and/or traction device (e.g., 20690, 20692) may be reported separately.

In simple words: This procedure fixes a broken bone in your lower back. The doctor uses a needle to put a small balloon inside the bone, inflates it to create space, and then fills the space with a special cement to make the bone strong again. Sometimes, the doctor might also take a small sample of the bone for testing.

This code describes a minimally invasive procedure to treat compression fractures in the lumbar spine. It involves inserting a needle into the vertebral body under imaging guidance (fluoroscopy or CT). A balloon-like device is then inserted and inflated to create space and restore vertebral height (kyphoplasty). Bone cement is injected into the cavity to stabilize the vertebra.The procedure includes fracture reduction and bone biopsy when performed. It also covers all necessary imaging guidance.

Example 1: A 65-year-old female with osteoporosis presents with a painful compression fracture in her L4 vertebra. Kyphoplasty is performed using 22514., A 50-year-old male sustains a compression fracture in his L1 vertebra during a car accident. Kyphoplasty is performed with bone biopsy to rule out pathological fracture (22514)., A 70-year-old female with multiple myeloma has a painful compression fracture in her L5 vertebra. Kyphoplasty is performed, along with additional levels treated with 22515.

Documentation should include: imaging reports confirming the compression fracture, type of anesthesia used, details of the procedure including levels treated and laterality of injection, any bone biopsy performed, and post-procedure assessment.

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