Overview of CPT Code 20705: Injection of corticosteroid into spinal canal
CPT Code 20705 refers to the injection of corticosteroids directly into the spinal canal to reduce inflammation and alleviate pain associated with spinal conditions.
When CPT Code 20705 is Used?
This procedure is indicated in various clinical scenarios.
- Chronic back pain due to herniated discs
- Spinal stenosis causing nerve root compression
- Radiculopathy with significant pain
- Inflammatory conditions affecting the spine
Symptoms Indicating This Procedure
Patients may report a variety of symptoms that lead to this procedure.
- Severe lower back pain
- Radiating pain down the legs
- Numbness or tingling in the extremities
- Weakness in the legs or feet
Causes and Risk Factors
Several factors can contribute to the need for this procedure.
- Degenerative disc disease
- Herniated or bulging discs
- Spinal injuries or trauma
- Chronic inflammatory conditions like arthritis
Diagnostic Tests Before Procedure
Certain tests are typically performed to guide the decision for this procedure.
- MRI of the spine to visualize disc and nerve root issues
- CT scan for detailed imaging of spinal structures
- X-rays to assess bone alignment and degeneration
- Electromyography (EMG) to evaluate nerve function
Procedure Description
The procedure involves several key steps to ensure safety and effectiveness.
- Patient is positioned comfortably, usually lying on their stomach.
- Skin is cleaned and sterilized at the injection site.
- Local anesthetic is administered to minimize discomfort.
- A needle is carefully inserted into the spinal canal using fluoroscopic guidance.
- Corticosteroid medication is injected into the epidural space.
- Needle is removed, and a bandage is applied to the injection site.
Preparation for the Procedure
Patients should follow specific guidelines before the procedure.
- Discuss all medications with the healthcare provider, especially blood thinners.
- Avoid eating or drinking for several hours prior to the procedure.
- Arrange for transportation home after the procedure.
- Wear comfortable clothing and avoid heavy lifting for a few days.
Recovery and Aftercare
Post-procedure care is essential for optimal recovery.
- Rest for the remainder of the day after the procedure.
- Apply ice to the injection site to reduce swelling.
- Avoid strenuous activities for at least 48 hours.
- Follow up with the healthcare provider to monitor progress.
Possible Complications
While generally safe, there are potential risks associated with this procedure.
- Infection at the injection site
- Bleeding or hematoma formation
- Nerve damage or worsening of symptoms
- Allergic reaction to the corticosteroid
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Post-Procedure Follow-Up
Monitoring after the procedure is crucial for assessing effectiveness.
- Initial follow-up within one week to assess pain relief.
- Further evaluations at one month and three months post-injection.
- Regular check-ins to monitor any recurrence of symptoms.
Alternative Treatments
There are several non-surgical options available for managing spinal pain.
- Physical therapy to strengthen back muscles.
- Chiropractic adjustments for spinal alignment.
- Acupuncture for pain relief.
- Oral medications such as NSAIDs or muscle relaxants.
Home Care Tips
Patients can take steps at home to aid recovery.
- Stay hydrated and maintain a balanced diet.
- Engage in gentle stretching exercises as advised.
- Use heat therapy to relax muscles and alleviate pain.
- Keep a pain diary to track symptoms and relief.
Patient Education & Prevention
Understanding how to prevent recurrence is vital.
- Maintain a healthy weight to reduce spinal stress.
- Practice good posture while sitting and standing.
- Engage in regular low-impact exercise to strengthen the back.
- Avoid repetitive heavy lifting and twisting motions.
Billing and Coding Information
CPT Code: 20705
Category: Surgery
Common Modifiers:
- 50 - Bilateral procedure
- RT - Right side
- LT - Left side
Average Cost and Insurance Coverage
Costs can vary based on location and insurance.
- Average cost ranges from $1,000 to $3,000.
- Most insurance plans cover this procedure with prior authorization.
- Out-of-pocket costs depend on the patient's deductible and copay.
Related CPT Codes
- 20610 - 'Arthrocentesis, aspiration of joint'
- 20605 - 'Arthrocentesis, aspiration, and/or injection into a major joint or bursa'
References and Sources
Frequently Asked Questions (FAQs)
How long does the procedure take?
The injection typically takes about 30 minutes.
Will I feel pain during the injection?
A local anesthetic is used to minimize discomfort.
How soon will I feel relief?
Some patients experience relief within a few days.
Are there any restrictions after the procedure?
Avoid strenuous activities for at least 48 hours.
