CPT® Code 22520

Deleted

Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection; thoracic

Percutaneous vertebroplasty is a minimally invasive procedure designed to stabilize compression fractures in the spine, particularly those caused by osteoporosis. This technique is also applicable for treating aggressive hemangiomas of the vertebral body and for providing palliative care for pathological fractures resulting from benign or malignant tumors in the spinal region. During the procedure, the patient is positioned prone, allowing for optimal access to the affected vertebral body. The use of imaging guidance, such as fluoroscopy or computed tomography (CT), is essential for accurately identifying the vertebral level that requires intervention. Local anesthesia is administered to ensure patient comfort throughout the procedure. A spinal needle is then carefully advanced into the vertebral body, where deep local and subperiosteal anesthesia is applied. If a biopsy is indicated, a small incision is made, and a bone biopsy needle is utilized to obtain a sample from the vertebral body, which is subsequently sent for pathological examination. Following the biopsy, the vertebroplasty is performed by injecting a mixture of polymethylmethacrylate (PMMA) bone cement and a contrast medium into the vertebral body. This mixture is monitored as it spreads through the intertrabecular bone marrow space, providing stabilization to the fractured vertebra. The procedure may involve injections on both sides of the vertebral body, depending on the clinical requirements. For coding purposes, the specific CPT® code 22520 is designated for percutaneous vertebroplasty of a single thoracic vertebra, while additional codes are available for lumbar vertebrae and for multiple vertebrae interventions.