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

This policy sets coding/billing rules for percutaneous vertebral augmentation (PVA) for osteoporotic vertebral compression fractures—Medicare covers medically necessary PVA (coverage for other conditions remains unchanged), venography performed during the operative session is not separately payable, and level-count exclusions do not apply for cancer-related diagnoses or multiple myeloma. Key requirements: follow NCCI and OPPS edits, report referring/ordering physician name and NPI when required, bill all same-day services by the same provider on one claim, and retain documentation (history, exam, and diagnostic test results) that supports medical necessity.