Medical Necessity Vertebroplasty

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Vertebroplasty - Mayo Clinic

https://www.mayoclinic.org/tests-procedures/vertebroplasty/about/pac-20385207

Vertebroplasty is a treatment that injects cement into a cracked or broken spinal bone to help relieve pain. Spinal bones are called vertebrae. Vertebroplasty is used most often to treat a type of injury called a compression fracture. These injuries are usually caused by osteoporosis, a condition that weakens bone. See more

0139-Vertebroplasty or Kyphoplasty: Medical Necessity …

https://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/Recovery-Audit-Program/Approved-RAC-Topics-Items/0139-Complex-Medical-Necessity-Vertebroplasty-and-Kyphoplasty-Vertebral-Augmentation

Description. Vertebroplasty and kyphoplasty will be reviewed for medical necessity whether billed as an initial procedure, a repeat procedure (beyond once in …

Medical Necessity Guidelines: Vertebroplasty and …

https://tuftshealthplan.com/documents/providers/guidelines/medical-necessity-guidelines/vertebroplasty

Vertebroplasty • Kyphoplasty CODES PROCEDURES REQUIRING PRIOR AUTHORIZATION: The plan will be using InterQual SmartSheet(s) for the following …

Percutaneous Vertebroplasty and Kyphoplasty

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-medical-drug/percutaneous-vertebroplasty-kyphoplasty.pdf

Medical management of vertebral body fractures can include analgesics, bed rest, and external bracing; however, despite these types of management, progressive kyphosis, …

Billing and Coding: Percutaneous Vertebral …

https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57752&LCDId=35130&CptHcpcsCode=22514

Payment of vertebroplasty and vertebral augmentation will be all-inclusive for the entire procedure (i.e. injection, intraosseous venography, etc.). No separate …

Back Pain - Invasive Procedures - Medical Clinical Policy …

https://www.aetna.com/cpb/medical/data/1_99/0016.html

Kyphoplasty (also known as balloon-assisted vertebroplasty) is a minimally-invasive orthopedic procedure, which has been developed to restore bone height lost due to …

Percutaneous Vertebroplasty, Kyphoplasty, and …

https://static.cigna.com/assets/chcp/pdf/coveragePolicies/medical/mm_0040_coveragepositioncriteria_kyphoplasty_vertebroplasty.pdf

Vertebroplasty is primarily used for treatment of osteoporotic fractures but has also been investigated for treatment of vertebral metastasis, vertebral involvement of multiple …

Medical Policy Percutaneous Vertebroplasty and …

https://www.bluecrossma.com/common/en_US/medical_policies/484%20Percutaneous%20Vertebroplasty%20and%20Sacroplasty%20prn.pdf

Vertebroplasty is a surgical procedure that involves the injection of synthetic cement (eg, polymethylmethacrylate, bis-glycidal dimethacrylate [Cortoss]3,) into a fractured vertebra. …

Vertebroplasty and Percutaneous Vertebral …

https://www.bluecrossnc.com/sites/default/files/document/attachment/services/public/pdfs/bluemedicare/medicalpolicy/Vertebroplasty_kyphoplasty_percutaneous.pdf

Percutaneous vertebroplasty is a therapeutic, interventional radiologic procedure, which consists of the injection of a biomaterial (usually …

Billing and Coding Guidelines - Centers for Medicare …

https://downloads.cms.gov/medicare-coverage-database/lcd_attachments/30516_9/L30516_RAD032_CBG_060111.pdf

The medical record must include documentation of the specific signs, symptoms and condition associated with the billed ICD-9 code. This information must be available to the …

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