Summary & Overview
CPT 0200T: Sacral Augmentation for Fractured Sacrum
CPT code 0200T designates a minimally invasive sacral augmentation procedure in which a provider injects cement material into one side of a fractured sacrum, optionally creating a cavity with a balloon or mechanical device and using imaging guidance and bone biopsy. This code is relevant nationally as sacral insufficiency fractures and traumatic sacral fractures are increasingly managed with percutaneous augmentation techniques to reduce pain and improve stability, affecting inpatient and outpatient procedural volumes and payer coverage policies.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for sacral augmentation, typical sites of service (hospital outpatient departments, ambulatory surgical centers, interventional radiology suites), and the service type classification. The publication outlines common modifiers and coding considerations where available. It also provides benchmarks and policy-relevant insights when present in payer determinations, and highlights areas where data are not available in the input.
This summary is intended for national audiences including coding professionals, reimbursement analysts, and clinical program managers seeking a clear description of what CPT code 0200T represents, where it is typically performed, and which major payers to consider when evaluating coverage and billing strategies.
Billing Code Overview
CPT code 0200T describes a sacral augmentation procedure in which the provider injects bone cement through a needle into one side of a fractured sacrum. The procedure may include creating a cavity in the sacral body using a balloon or mechanical device, and may be performed with imaging guidance and bone biopsy.
Service Type: Minimally invasive sacral augmentation / vertebral augmentation
Typical Site of Service: Hospital outpatient department or ambulatory surgical center, with possible performance in an interventional radiology suite or similar imaging-equipped procedural setting.
Clinical & Coding Specifications
Clinical Context
A 78-year-old female with severe osteoporosis presents with progressive low back and buttock pain after a ground-level fall. Imaging (CT and MRI) demonstrates an acute non-displaced fracture of the sacral ala with persistent pain limiting ambulation despite conservative measures (analgesics, physical therapy, and bracing) for 4–6 weeks. The interventional spine team schedules a sacroplasty under conscious sedation in an outpatient interventional radiology suite. The procedure is performed with fluoroscopic or CT guidance: after sterile preparation and local anesthesia, a percutaneous needle is advanced into the sacral fracture under image guidance. Bone cement (polymethylmethacrylate) is injected into the fracture zone; a balloon or mechanical cavity-creation device may be used prior to cement placement depending on anatomy. A single-side augmentation is completed with intra-procedural imaging to confirm cement distribution and to monitor for extravasation. The patient is observed post-procedure for recovery from sedation and neurovascular status, receives post-procedure pain assessment and discharge instructions, and is followed up in clinic within 1–2 weeks for evaluation of pain relief and mobilization.
Typical Site of Service
Outpatient interventional radiology or ambulatory surgery center; may also be performed in a hospital-based procedure suite depending on patient comorbidities.
Service Type
Percutaneous sacral augmentation (sacroplasty) with image guidance and possible cavity creation — minimally invasive cement augmentation to stabilize sacral insufficiency or traumatic sacral fractures and reduce pain.
Coding Specifications
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