Rubrica

CPT 22510 · Vertebral Augmentation

Vertebroplasty — Cervicothoracic (1st level)

Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection; cervicothoracic.

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95
Payors tracked
72
Cover this CPT (76%)
46
Require prior auth (48%)
1
Flag investigational

Rubrica tracks payor coverage for CPT 22510 (Vertebroplasty — Cervicothoracic (1st level)) across 95 payors — every Medicare MAC, the major commercial plans, the BCBS family, all 50-state Medicaid programs, and selected workers' comp and auto/PIP carriers. Aggregate coverage patterns are shown below; full payor-specific criteria, source citations, and last-reviewed dates are available to signed-in practitioners.

Top payors covering CPT 22510

Sample of 12 payors with coverage for this code. Sign in for the complete payor list, verbatim criteria, denial-risk score, and source citations for each.

PayorCoveragePrior auth
Aetna Better Health of FloridaCoveredPrior auth
Aetna Better Health of MarylandCoveredPrior auth
Aetna Better Health of New JerseyCoveredPrior auth
Aetna Medicare AdvantageCoveredPrior auth
Alabama MedicaidCoveredPrior auth
Alabama Medicaid (FFS)CoveredPrior auth
Allstate Auto / PIPCoveredPrior auth
AlohaCareCoveredNo PA
AmTrust Financial WCCoveredPrior auth
AmeriHealth Caritas Family (ACPA / AC Northeast / Keystone First) — PA HealthChoicesCoveredPrior auth
Arkansas Blue Cross Blue ShieldCoveredNo PA
Arkansas Total CareCoveredNo PA

Coverage themes for CPT 22510

Common patterns across the 95 payors we track. Specific criteria per payor are available after sign-in.

Most payors require ≥4 weeks of conservative care before approving 22510.

47 of 95 payors require imaging concordance documentation.

Of the 95 payors with coverage records for CPT 22510, 46 require prior authorization, 26 cover without prior authorization, and 1 flag the procedure as investigational or experimental under current criteria.

See the policy for every payor.

Sign in to see verbatim coverage criteria, conservative-care duration requirements, imaging concordance rules, and the documentation each payor wants in the submission.

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