Optum Vertebroplasty/Kyphoplasty prior authorization requirements (2026)

What Optum generally requires to approve Vertebroplasty/Kyphoplasty (CPT 22510, 22511, 22512, 22513, 22514, 22515), for Commercial plans. Yes. Optum generally requires prior authorization for Vertebroplasty/Kyphoplasty (CPT 22510, 22511, 22512, 22513, 22514, 22515).

General reference compiled from public sources. This is not a coverage determination or medical advice. Always confirm current requirements with Optum before submitting.

Medical-necessity criteria Optum generally applies

(1) Acute VCF on MRI STIR ≤6 months; (2) Osteoporosis (DEXA T-score ≤-2.5) or fragility fracture; (3) VAS ≥6/10; (4) Conservative management failure ≥3–4 weeks; (5) No neurological compromise requiring decompression

Diagnoses that commonly support medical necessity

ICD-10-CM diagnoses frequently associated with medical necessity for Vertebroplasty/Kyphoplasty. Confirm the covered diagnosis list against the current Optum policy.

M80.08XAAge-related osteoporosis with current pathological fracture, vertebra(e), initial encounterM48.50XACollapsed vertebra, not elsewhere classified, site unspecified, initial encounter

Commonly required documentation

  • MRI with STIR
  • DEXA
  • X-rays
  • VAS
  • conservative records

How to submit

Source

MRI STIR edema required. Online submission with all documents may receive same-day decision.

Frequently asked questions

Does Optum require prior authorization for Vertebroplasty/Kyphoplasty?

Yes. Optum generally requires prior authorization for Vertebroplasty/Kyphoplasty (CPT 22510, 22511, 22512, 22513, 22514, 22515).

What does Optum require to approve Vertebroplasty/Kyphoplasty?

(1) Acute VCF on MRI STIR ≤6 months; (2) Osteoporosis (DEXA T-score ≤-2.5) or fragility fracture; (3) VAS ≥6/10; (4) Conservative management failure ≥3–4 weeks; (5) No neurological compromise requiring decompression Always confirm against the current Optum policy.

How long does a Optum prior authorization take?

Optum typically decides Vertebroplasty/Kyphoplasty requests in about 2 days. Timeframes vary; check the payer portal.

Submitting Vertebroplasty/Kyphoplasty to Optum?

Praxigen checks your clinical note against these criteria before you submit and drafts a policy-cited appeal if it is denied. You review and submit; nothing is sent automatically.

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Other Optum prior authorization requirements

Anterior Cervical Discectomy and FusionArthroscopic Hip Surgery for Impingement Syndrome Including Labral RepairDorsal Column (Lumbar) Neurostimulators: Trial or ImplantationKnee ArthroscopyLumbar Spinal FusionPain Injections - SpineShoulder Arthroscopy Rotator Cuff RepairTotal Knee Arthroplasty

Related guides

Why was my prior authorization denied? Top reasons and how to fix eachHow to write a prior authorization appeal that cites policy