Billing and Coding: Intraosseous Basivertebral Nerve Ablation

Intraosseous BVN ablation is covered only for vertebral bodies L3–S1 when imaging documents Modic type 1 or 2 changes and there is no prior ablation of the targeted vertebral body; these requirements must be indicated on the claim with the KX modifier. Coverage is limited to a lifetime maximum of four treated vertebral bodies (L3–S1) per beneficiary, with no more than two levels treated per session, and is non-covered for patients who are skeletally immature or who have specified contraindicating diagnoses or who receive biologic/medicament injections into the vertebral body.

"Ablation of the intraosseous basivertebral nerve (BVN) is covered only when performed within vertebral bodies L3, L4, L5, or S1."

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