Summary & Overview
CPT 22512: Percutaneous Vertebroplasty, Additional Vertebral Body
Headline: CPT code 22512: Additional-Level Percutaneous Vertebroplasty, Image-Guided
Lead: CPT code 22512 documents the repeat performance, during the same session, of percutaneous vertebroplasty on each additional cervicothoracic or lumbosacral vertebral body. The code captures image-guided injections of bone cement for surgical repair of fractured vertebrae, commonly used for osteoporotic compression fractures or when diagnostic biopsy is required.
CPT code 22512 represents an add-on procedural code for repeat vertebroplasty at additional vertebral levels performed in the same operative session. Nationally, vertebroplasty is an important intervention for selected patients with painful vertebral compression fractures that have not responded to conservative care; accurate coding affects clinical documentation and payer adjudication for multi-level treatments. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise explanation of the clinical context and typical sites of service, common billing considerations for same-session additional-level procedures, and a summary of which payers are included in the review. The publication also outlines related procedural coding practice areas and areas where documentation is essential for claims processing. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 22512 describes the repeat performance, in the same session as percutaneous vertebroplasty, of the procedure on each additional cervicothoracic or lumbosacral vertebral body. The procedure entails percutaneous vertebroplasty — the surgical repair of a fractured vertebra with injection of bone cement — performed under imaging guidance. The code applies when the provider performs cervicothoracic or lumbosacral vertebroplasty and repeats the procedure on additional vertebral bodies during the same operative session.
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Service type: Percutaneous vertebroplasty repeated on additional vertebral bodies during the same session
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Typical site of service: Hospital inpatient, hospital outpatient, or ambulatory surgical center settings where image-guided spinal procedures are performed
Clinical & Coding Specifications
Clinical Context
A 78-year-old female with known osteoporosis presents with acute onset mid-back pain after a minor fall. Conservative management including oral analgesics, bracing, and physical therapy over two weeks produced inadequate pain relief and limited mobilization. Imaging with CT and fluoroscopy-guided MRI correlation demonstrates a painful compression fracture at the L2 vertebral body with cortical collapse and persistent height loss. The interventional spine team evaluates the patient, confirms candidacy for percutaneous vertebroplasty, obtains informed consent, and schedules the procedure under conscious sedation in an outpatient interventional radiology suite. During the session the provider performs image-guided transpedicular access to the L2 vertebral body, obtains aspirate/core biopsy for culture and pathology when indicated, and injects polymethylmethacrylate cement to stabilize the fracture and relieve pain. If additional symptomatic vertebral levels are identified and treated in the same session, 22512 is reported for each additional vertebral body beyond the first. Typical peri-procedure workflow includes pre-procedure labs and medication review, intra-procedure imaging guidance (fluoroscopy/CT), sterile technique, post-procedure monitoring for neurovascular or cement leakage complications, and discharge with activity and follow-up instructions.
Coding Specifications
- Below are the most clinically relevant modifiers for this procedure along with when to use them.
| Modifier | Description | When to Use |
|---|---|---|