Awareness : Newsletter Articles

Vertebroplasty, Vertebral Augmentation; Percutaneous Revision to the Part A and Part B LCD

The vertebroplasty, vertebral augmentation; percutaneous local coverage determination (LCD) was revised in the “CPT®/HCPCS Codes” section of the LCD to remove CPT® code 76380 (Computed Tomography, limited or localized follow-up study. The remaining procedure codes listed in the LCD are inclusive of all imaging guidance.

In addition, based on an annual review of the LCD, it was determined that the language in the “Coverage Indications, Limitations, and/or Medical Necessity” section of the LCD does not represent direct quotation from the Centers for Medicare & Medicaid Services (CMS) sources. Therefore, this LCD is being revised to assure consistency with the manual language.

Effective date

The LCD revision to remove CPT® code 76380 is effective for claims processed on or after April 17, 2018. The LCD revision to assure consistency with manual language is effective for services rendered on or after April 17, 2018. LCDs are available through the CMS Medicare coverage database at https://www.cms.gov/medicare-coverage-database/overview-and-quick-search.aspx