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Thoracic and Lumbar Vertebroplasties Performed in US Medicare Enrollees, 2001-2005
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To the Editor: Percutaneous vertebroplasty involves the vertebral injection of polymethylmethacrylate cement. Although some indication that this procedure is safe and effective for treating osteoporotic compression fractures exists,1 the US Medicare program promulgated no national coverage policies for this procedure after reviewing the available nonrandomized evidence.2 Nevertheless, local Medicare contractors in multiple jurisdictions have covered vertebroplasty for various indications since as least 2001. We examined vertebroplasty-use patterns in Medicare patients for 2001-2005.
Methods
Using vertebroplasty-related Current Procedural Terminology, 4th Edition (CPT-4), codes 22520 (primary thoracic vertebroplasty) and 22521 (primary lumbar vertebroplasty), we performed cross-sectional analyses of aggregate 2001-2005 fee-for-service data from the Medicare all-age Part B Extract Summary System,3 which excludes denied claims and claims for Medicare managed care enrollees. Annual primary vertebroplasty rates (which exclude additional vertebral levels also treated) were therefore expressed per 100 000 Part B fee-for-service enrollees.
Part B Extract Summary System data are cross-stratified by the billing . . . [Full Text of this Article]
Darryl T. Gray, MD, ScD
darryl.gray@ahrq.hhs.gov
Center for Quality Improvement and Patient Safety
Agency for Healthcare Research and Quality
Rockville, Maryland
William Hollingworth, PhD
Department of Social Medicine, University of Bristol
Bristol, England
Nneka Onwudiwe, PharmD
Pharmaceutical Health Services Research
University of Maryland School of Pharmacy
Baltimore
Richard A. Deyo, MD, MPH
Department of Medicine
University of Washington
Seattle
Jeffrey G. Jarvik, MD, MPH
Department of Radiology
University of Washington
Seattle
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