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

This billing and coding article provides coding, documentation, and billing instructions for percutaneous vertebral augmentation (PVA) for vertebral compression fractures and defers to LCD L35130 for clinical reasonable-and-necessary coverage determinations. Key rules include per-vertebral-body CPT reporting (22513/22514/22515 etc.), all-inclusive payment for intraoperative components (venography, injection), bone biopsy is integral and not separately payable unless at a different site/session with modifier 59/XS and supporting documentation, and assistant-at-surgery services are not payable.

"Percutaneous vertebral augmentation (PVA) is covered for treatment of vertebral compression fracture (VCF) when determined reasonable and necessary per Local Coverage Determination L35130."

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