Overview of CPT Code 15790:Injection of Biologic Agent into Soft Tissue
CPT Code 15790 refers to the injection of a biologic agent into soft tissue, typically used to treat conditions such as tendonitis, bursitis, or other inflammatory conditions. This procedure aims to reduce inflammation and promote healing in affected areas.
When CPT Code 15790 is Used?
This code is applicable in various clinical scenarios where biologic agents are indicated.
- Chronic tendonitis in the shoulder or elbow.
- Bursitis in the hip or knee.
- Plantar fasciitis causing significant pain.
- Soft tissue injuries that have not responded to conservative treatments.
Symptoms Indicating This Procedure
Patients may present with a variety of symptoms that warrant this procedure.
- Persistent pain in the affected joint or soft tissue.
- Swelling and tenderness in the area.
- Limited range of motion due to pain.
- Symptoms not improving with rest or physical therapy.
Causes and Risk Factors
Understanding the underlying causes and risk factors can help in managing conditions treated with this procedure.
- Overuse injuries from repetitive activities.
- Age-related degeneration of soft tissues.
- Previous injuries or trauma to the area.
- Certain medical conditions like diabetes or rheumatoid arthritis.
Diagnostic Tests Before Procedure
Several diagnostic tests may be performed to confirm the need for this injection.
- X-rays to rule out fractures or bone abnormalities.
- MRI to assess soft tissue damage.
- Ultrasound to visualize inflammation or fluid accumulation.
- Blood tests to check for underlying inflammatory conditions.
Procedure Description
The injection procedure is typically straightforward and performed in an outpatient setting.
- Patient is positioned comfortably and the injection site is cleaned.
- A local anesthetic may be applied to minimize discomfort.
- The biologic agent is drawn into a syringe.
- The physician carefully injects the agent into the targeted soft tissue.
- Post-injection care instructions are provided.
Preparation for the Procedure
Proper preparation can enhance the effectiveness of the procedure.
- Inform the physician of any allergies, especially to medications.
- Avoid blood thinners or anti-inflammatory medications for a few days prior.
- Wear loose-fitting clothing to allow easy access to the injection site.
- Arrange for transportation if sedation is used.
Recovery and Aftercare
Post-procedure care is essential for optimal recovery.
- Rest the affected area for 24-48 hours.
- Apply ice to reduce swelling and discomfort.
- Avoid strenuous activities for a few days.
- Follow up with physical therapy as recommended.
Possible Complications
While generally safe, there are potential risks associated with the procedure.
- Infection at the injection site.
- Allergic reaction to the biologic agent.
- Increased pain or swelling post-injection.
- Nerve or tissue damage if not performed correctly.
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Post-Procedure Follow-Up
Monitoring after the procedure is crucial for assessing effectiveness.
- Follow-up appointment within 1-2 weeks to evaluate response.
- Additional imaging may be required if symptoms persist.
- Adjustments to treatment plan based on recovery progress.
Alternative Treatments
There are several non-surgical options available for managing soft tissue conditions.
- Physical therapy to strengthen and rehabilitate the area.
- Corticosteroid injections for inflammation.
- Oral anti-inflammatory medications.
- Rest and ice therapy to reduce symptoms.
Home Care Tips
Patients can take several steps at home to aid recovery.
- Keep the injection site clean and dry.
- Use ice packs to manage swelling.
- Engage in gentle stretching exercises as tolerated.
- Monitor for any signs of infection or unusual symptoms.
Patient Education & Prevention
Educating patients on prevention can help avoid recurrence.
- Engage in proper warm-up and cool-down exercises.
- Avoid repetitive strain on joints and soft tissues.
- Maintain a healthy weight to reduce stress on joints.
- Consider ergonomic adjustments in work and daily activities.
Billing and Coding Information
CPT Code: 15790
Category: Surgical Procedures
Common Modifiers:
- 50 - Bilateral procedure
- RT - Right side
- LT - Left side
Average Cost and Insurance Coverage
Costs can vary based on location and insurance coverage.
- Average cost ranges from $300 to $800 per injection.
- Many insurance plans cover the procedure with prior authorization.
- Out-of-pocket costs may apply depending on the plan.
Related CPT Codes
- 20610 - 'Arthrocentesis, aspiration of joint'
- 20605 - 'Arthrocentesis, aspiration, and/or injection into a major joint or bursa'
- 20600 - Aspirational Joint Injection, Aspiration, or Injection of a Major Joint or Bursa
- 20604 - 'Arthrocentesis, aspiration of joint'
References and Sources
Frequently Asked Questions (FAQs)
What is a biologic agent?
A biologic agent is a substance derived from living organisms used to treat various medical conditions.
How long does the procedure take?
The injection procedure typically takes about 15 to 30 minutes.
Will I feel pain during the injection?
A local anesthetic is usually applied to minimize discomfort during the injection.
How soon can I return to normal activities?
Most patients can resume normal activities within a few days, depending on the area treated.
