CPT® Code 22523

Deleted

Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, 1 vertebral body, unilateral or bilateral cannulation (eg, kyphoplasty); thoracic

Percutaneous vertebral augmentation is a minimally invasive procedure designed to treat compression fractures of the vertebrae, which can occur due to various conditions such as osteoporosis, multiple myeloma, primary or metastatic malignant lesions, benign lesions, or traumatic injuries to the spine. This procedure is particularly beneficial for patients suffering from debilitating pain and instability caused by these fractures. During the procedure, the patient is typically positioned in a prone manner, allowing the physician to access the affected vertebra effectively. The use of fluoroscopic guidance is essential, as it provides real-time imaging to ensure accurate placement of instruments and materials. A small incision is made over the targeted vertebra, and a working channel is created by advancing a needle to the appropriate location within the vertebra. This channel allows for the potential collection of biopsy samples if necessary. Following this, a guidewire is introduced, and a cannula is placed over it to facilitate the introduction of a mechanical device, which is used to create a cavity within the vertebra. This cavity is then filled with bone graft material or polymethylmethacrylate (PMMA) bone cement, which is mixed with contrast medium to allow for visual confirmation of the filling process. The procedure can be performed unilaterally or bilaterally, depending on the specific needs of the patient and the extent of the fracture. The CPT® code 22523 specifically refers to the augmentation of a single thoracic vertebra, with additional codes available for lumbar vertebrae and for multiple vertebrae as needed.