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New coverage information for Vertebral/Kyphoplasty

Date: Jan 16, 2020

Question:

Can you please help me understand the new LCD for vertebral/kyphoplasty? Am I understanding correctly that the patient has to be seen by a neurologist prior to the procedure being done? And did they remove all the previous ICD-10-CM codes? The new policy I'm looking at only shows: M80.08XA - Age-related osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture; M80.08XS - Age-related osteoporosis with current pathological fracture, vertebra(e), sequela; M80.88XA - Other osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture; M80.88XS - Other osteoporosis with current pathological fracture, vertebra(e), sequela I'm really confused by this. I need to understand it better before I let my IR know about these changes. I think they took place.

Question ID : 13486
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