CPT® Code 22521

Deleted

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

Percutaneous vertebroplasty is a minimally invasive procedure aimed at stabilizing compression fractures in the spine, particularly those caused by osteoporosis. This procedure 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 the physician to access the lumbar vertebrae effectively. The use of imaging techniques, 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 targeted vertebral body, where deep local and subperiosteal anesthesia is applied. If a biopsy is indicated, a small incision is made, and a specialized bone biopsy needle is utilized to obtain a sample from the vertebral body for pathological analysis. Following this, the vertebroplasty is performed by injecting a mixture of polymethylmethacrylate (PMMA) bone cement and a contrast medium into the vertebral body, which helps to visualize the distribution of the cement within the bone marrow space. The procedure may involve injections on both sides of the vertebral body, depending on the clinical requirements. This technique is specifically coded under CPT® Code 22521 for a single lumbar vertebra, with additional codes available for thoracic vertebrae and subsequent lumbar vertebrae as necessary.