Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF)

Percutaneous vertebroplasty and percutaneous vertebral augmentation are covered for acute or subacute osteoporotic vertebral compression fractures (T1–L5) when advanced imaging documents an acute fracture and the patient has significant pain (NRS/VAS ≥8 if hospitalized; ≥5 if non-hospitalized) despite optimal non-surgical management. Coverage also extends to selected osteolytic malignant vertebral fractures without major cortical bone involvement; exclusions include active infection, pregnancy, uncorrected coagulopathy, neurological compromise, spinal instability, and procedures treating more than three vertebral levels at once.

"Percutaneous vertebroplasty (PVP) or percutaneous vertebral augmentation (PVA/kyphoplasty) is reasonable and necessary for painful, debilitating osteoporotic vertebral compression fractures (VCF) t..."

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