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

This billing and coding guidance complements LCD L38737 for percutaneous vertebral augmentation (PVA) for vertebral compression fracture and focuses on billing, coding edits, and documentation requirements. Key rules: venography performed during the operative session is not separately payable; procedure codes may be subject to NCCI/OPPS edits so providers must verify billing rules; all same-day services by the same provider must be billed on one claim; and the medical record must document medical necessity (history, exam, and relevant test results) and include referring physician name/NPI when required.

"No separate payment is allowed for venography performed during the operative session for PVA and venography should not be billed separately."

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