Overview of CPT Code 20979:percutaneous-vertebroplasty
Percutaneous vertebroplasty is a minimally invasive procedure used to treat vertebral compression fractures, typically caused by osteoporosis or trauma. The procedure involves the injection of a bone cement into the fractured vertebra to stabilize it and alleviate pain.
When CPT Code 20979 is Used?
Percutaneous vertebroplasty is indicated in specific clinical scenarios.
- Patients with painful vertebral compression fractures due to osteoporosis.
- Fractures resulting from malignancy or metastatic disease.
- Patients who have not responded to conservative treatments such as pain medication or physical therapy.
Symptoms Indicating This Procedure
Patients typically report various symptoms that may lead to the consideration of this procedure.
- Severe back pain localized to the site of the fracture.
- Pain that worsens with movement or standing.
- Loss of height or deformity in the spine.
- Neurological symptoms such as numbness or weakness in the legs.
Causes and Risk Factors
Understanding the causes and risk factors can help in identifying patients who may benefit from this procedure.
- Osteoporosis leading to weakened bones.
- Trauma or injury to the spine.
- Certain cancers that metastasize to the vertebrae.
- Age-related bone density loss.
Diagnostic Tests Before Procedure
Several diagnostic tests are performed to confirm the need for vertebroplasty.
- X-rays to visualize the fracture.
- MRI to assess the extent of the fracture and surrounding tissues.
- CT scans for detailed imaging of the vertebrae.
Procedure Description
The procedure is performed under local anesthesia and sedation.
- The patient is positioned comfortably, usually lying on their stomach.
- A small incision is made in the skin over the affected vertebra.
- A needle is inserted through the incision and guided into the fractured vertebra using imaging guidance.
- Bone cement is mixed and injected into the vertebra to stabilize it.
- The needle is removed, and the incision is closed with a bandage.
Preparation for the Procedure
Patients should follow specific guidelines to prepare for the procedure.
- Discuss any medications with the healthcare provider, especially blood thinners.
- Avoid eating or drinking for several hours before the procedure.
- Arrange for transportation home after the procedure due to sedation.
Recovery and Aftercare
Post-procedure recovery is generally quick, but care is essential.
- Patients may experience some soreness at the injection site.
- Rest is recommended for the first few days.
- Pain relief medications may be prescribed as needed.
- Follow-up appointments are necessary to monitor recovery.
Possible Complications
While generally safe, there are potential risks associated with the procedure.
- Infection at the injection site.
- Bleeding or hematoma formation.
- Allergic reaction to the bone cement.
- Nerve damage or worsening of symptoms.
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Post-Procedure Follow-Up
Follow-up care is crucial for ensuring proper recovery.
- Initial follow-up within one week to assess pain relief and recovery.
- Additional follow-ups at one month and three months post-procedure.
- Long-term monitoring for any recurrence of symptoms.
Alternative Treatments
There are several non-surgical options available for managing vertebral compression fractures.
- Physical therapy to strengthen back muscles.
- Pain management with medications.
- Bracing to support the spine.
- Kyphoplasty, a similar procedure that also restores vertebral height.
Home Care Tips
Patients can take several steps at home to aid recovery.
- Avoid heavy lifting and strenuous activities for a few weeks.
- Use ice packs on the injection site to reduce swelling.
- Engage in gentle stretching and walking as tolerated.
Patient Education & Prevention
Educating patients on prevention can help reduce the risk of future fractures.
- Maintain a healthy diet rich in calcium and vitamin D.
- Engage in weight-bearing exercises to strengthen bones.
- Avoid smoking and limit alcohol consumption.
Billing and Coding Information
CPT Code: 20979
Category: Surgery
Common Modifiers:
- 50 - Bilateral procedure
- LT - Left side
- RT - Right side
Average Cost and Insurance Coverage
The cost of the procedure can vary based on several factors.
- Average cost ranges from $5,000 to $15,000.
- Most insurance plans cover the procedure if medically necessary.
- Patients should verify coverage with their insurance provider.
Related CPT Codes
References and Sources
Frequently Asked Questions (FAQs)
What is percutaneous vertebroplasty?
It is a minimally invasive procedure to treat vertebral compression fractures.
How long does the procedure take?
The procedure typically takes about 1 to 2 hours.
Is the procedure painful?
Most patients report minimal discomfort during the procedure.
What is the recovery time?
Many patients experience relief within a few days and can return to normal activities.
