REIMBURSEMENT VERTEBRAL AUGMENTATION PROCEDURES

REIMBURSEMENT CODING AND PAYMENT GUIDES

To ensure that a patient meets the medically necessary policy criteria, or to find out if coverage prior authorization/predetermination is required, please contact the patient’s payer directly. Medtronic provides this information for your convenience only. It is the responsibility of the provider to determine coverage and submit appropriate codes, modifiers, and charges for the services rendered. The information below provides assistance for FDA approved or cleared indications.

The coding includes information on the diagnosis and procedure codes applicable to all sites-of-service to be used when billing, along with Medicare national average payment rates. For specific coding assistance with your facility, please contact your Medtronic sales or health economics representative.

pdf Balloon Kyphoplasty Reimbursement Guide (.pdf)

ICD-10 codes, CPT codes, and Medicare average payment rates for balloon kyphoplasty (BKP).

2.7MB

DOWNLOAD BKP GUIDE
pdf Vertebral Augmentation and Radiofrequency Ablation Reimbursement Guide (.pdf)

Device C-codes, CPT codes, and Medicare average payment rates for vertebral augmentation (VA) and radiofrequency ablation (RA).

2.7MB

DOWNLOAD VA AND RA GUIDE
pdf Vertebroplasty Reimbursement Guide (.pdf)

ICD-10 codes, CPT codes, and Medicare average payment rates for vertebroplasty.

263KB

DOWNLOAD VERTEBROPLASTY GUIDE

LCD Requirement Sample Checklists (By MAC) and additional resources

Please utilize the below checklists to confirm that LCD requirements are met. These resources are made available by Medtronic to assist healthcare professionals in completing the reimbursement process. Additionally, Medtronic provides reimbursement resources for patients with no previous history of osteoporosis.

VCF Medicare Coverage - (11:56)

Learn more about Medicare coverage and reimbursement for VCF.
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pdf FCSO LCD Requirement Sample Checklist (.pdf)

Medicare (FCSO) Percutaneous Vertebral Augmentation (PVA) for VCF LCD requirement sample checklist.

137KB

pdf NGS LCD Requirement Sample Checklist (.pdf)

Medicare (NGS) Percutaneous Vertebral Augmentation (PVA) for osteoporotic VCF LCD requirement sample checklist.

120KB

pdf CGS LCD Requirement Sample Checklist (.pdf)

Medicare (CGS) Percutaneous Vertebral Augmentation (PVA) for VCF LCD requirement sample checklist.

155KB

pdf Novitas LCD Requirement Sample Checklist (.pdf)

Medicare (Novitas) Percutaneous Vertebral Augmentation (PVA) for VCF LCD requirement sample checklist.

136KB

pdf Noridian LCD Requirement Sample Checklist (.pdf)

Medicare (Noridian) Percutaneous Vertebral Augmentation (PVA) for osteoporotic VCF LCD requirement sample checklist.

160KB

pdf Palmetto LCD Requirement Sample Checklist (.pdf)

Medicare (Palmetto) Percutaneous Vertebral Augmentation (PVA) for osteoporotic VCF LCD requirement sample checklist.

110KB

pdf VCF Resource For No History Of Osteoporosis (.pdf)

Reimbursement resources for Vertebral Compression Fracture with no history of Osteoporosis.

265KB

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800-876-3133

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