Billing and Coding: Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF)

Percutaneous vertebral augmentation (PVA) is covered for osteoporotic vertebral compression fractures when medically necessary and consistent with the related LCD; coverage may also be available for other medically necessary vertebral augmentation procedures. Claims must include a valid, specific ICD-10-CM diagnosis code, and the medical record must document medical necessity (history, physical exam, diagnostic tests). Billing is subject to NCCI/OPPS edits, venography performed intraoperatively is not separately payable, and referring physician name/NPI must be reported when required.

"Percutaneous vertebral augmentation (PVA) is covered for osteoporotic vertebral compression fracture (VCF) when medically necessary and consistent with the related Local Coverage Determination (LCD)."

Sign up to see full coverage criteria, indications, and limitations.