CPT® Code 0200T

Percutaneous sacral augmentation (sacroplasty), unilateral injection(s), including the use of a balloon or mechanical device, when used, 1 or more needles, includes imaging guidance and bone biopsy, when performed

Percutaneous sacroplasty, as described by CPT® Code 0200T, is a minimally invasive procedure aimed at treating sacral insufficiency fractures, which are particularly prevalent among postmenopausal women suffering from osteoporosis. These fractures can also occur in individuals with additional risk factors such as rheumatoid arthritis, those undergoing steroid therapy, patients with a history of hip replacement surgeries, and individuals who have received radiation therapy to the pelvic region. Although sacral insufficiency fractures may heal with conservative management, including bed rest and pain relief, they frequently result in significant and debilitating pain that can severely impact a patient's quality of life. The procedure utilizes fluoroscopic imaging guidance to accurately place one or more trocar needles into the sacrum, specifically targeting the marrow cavity. When a single needle is employed, it is strategically positioned between the sacroiliac joint and the sacral foramen. During the procedure, a mixture of polymethylmethacrylate (PMMA) and sterile barium is injected into the marrow space through the indwelling needle, allowing for real-time visualization of the PMMA as it fills the cavity, ensuring correct placement. In cases where a unilateral injection is performed, one or more needles are inserted on the same side of the sacrum. If a bilateral injection is required, the procedure is repeated on the opposite side using two or more needles. Additionally, a bone biopsy may be conducted during the augmentation process to gather further diagnostic information.