Vertical Expandable Prosthetic Titanium Rib

This policy covers placement of the Vertical Expandable Prosthetic Titanium Rib (VEPTR) — a curved, expandable rib‑based rod positioned between ribs or between ribs and spine/pelvis — for treating progressive thoracic insufficiency syndrome and related rib/chest‑wall defects in skeletally immature patients (generally ≥6 months to skeletal maturity) and for certain progressive congenital, neuromuscular, idiopathic, or syndromic scoliosis when associated with or at risk of TIS. Implantation should occur in specialized centers, the device is intended for serial expansions (~every 4–6 months) with possible exchanges/revisions, evidence is limited to small noncomparative series with variable pulmonary benefit, use for scoliosis without TIS is considered experimental, and coding is typically reported with unlisted CPT 22899.

"Treatment of progressive thoracic insufficiency syndrome due to rib and/or chest wall defects in infants and children aged ≥6 months up to skeletal maturity"