Overview of CPT Code 21242: Injection of bone cement into vertebra
CPT Code 21242 refers to the procedure of injecting bone cement into a vertebra to stabilize it, often used in cases of vertebral compression fractures.
When CPT Code 21242 is Used?
This procedure is indicated in specific clinical scenarios.
- Vertebral compression fractures due to osteoporosis.
- Pathological fractures from tumors affecting the vertebrae.
- Pain management in patients with vertebral fractures not responding to conservative treatment.
Symptoms Indicating This Procedure
Patients may report various symptoms that lead to this procedure.
- Severe back pain localized to the affected vertebra.
- Pain that worsens with movement or weight-bearing.
- Numbness or weakness in the legs if nerve compression occurs.
Causes and Risk Factors
Understanding the causes and risk factors can help in prevention and management.
- Osteoporosis leading to weakened bones.
- Cancer that metastasizes to the spine.
- Trauma or injury to the spine.
Diagnostic Tests Before Procedure
Several tests may be conducted to confirm the need for this procedure.
- X-rays to visualize the fracture.
- MRI to assess the extent of the fracture and any associated soft tissue damage.
- CT scans for detailed imaging of the vertebra.
Procedure Description
The procedure involves several key steps.
- Patient is positioned comfortably, often lying on their stomach.
- Local anesthesia is administered to numb the area.
- A needle is inserted into the fractured vertebra under fluoroscopic guidance.
- Bone cement is injected into the vertebra to stabilize it.
- The needle is removed, and the site is bandaged.
Preparation for the Procedure
Proper preparation is essential for a successful procedure.
- Discuss any medications with your doctor, especially blood thinners.
- Arrange for someone to drive you home post-procedure.
- Follow any fasting instructions if sedation is planned.
Recovery and Aftercare
Post-procedure care is crucial for recovery.
- Rest for the first 24 hours after the procedure.
- Gradually resume normal activities as tolerated.
- Follow up with your doctor for pain management and assessment.
Possible Complications
While generally safe, there are potential risks involved.
- Infection at the injection site.
- Allergic reaction to the bone cement.
- Increased pain or new fractures in adjacent vertebrae.
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Post-Procedure Follow-Up
Monitoring after the procedure is important.
- Follow-up appointment within 1-2 weeks to assess recovery.
- Regular check-ups to monitor for any complications.
- Imaging studies may be repeated to evaluate the success of the procedure.
Alternative Treatments
There are non-surgical options available.
- Physical therapy to strengthen back muscles.
- Pain management with medications.
- Bracing to support the spine.
Home Care Tips
Simple tips can aid in recovery at home.
- Apply ice to the injection site to reduce swelling.
- Take prescribed pain medications as directed.
- Avoid heavy lifting and strenuous activities for a few weeks.
Patient Education & Prevention
Education is key to preventing future issues.
- Maintain a healthy diet rich in calcium and vitamin D.
- Engage in weight-bearing exercises to strengthen bones.
- Regular screenings for osteoporosis, especially in at-risk populations.
Billing and Coding Information
CPT Code: 21242
Category: Surgical Procedures
Common Modifiers:
- -50
- -LT
- -RT
Average Cost and Insurance Coverage
Costs can vary based on several factors.
- Average cost ranges from $5,000 to $15,000 depending on facility and location.
- Most insurance plans cover this procedure if deemed medically necessary.
Related CPT Codes
References and Sources
Frequently Asked Questions (FAQs)
What is the purpose of the injection?
The injection stabilizes the vertebra and alleviates pain.
Is the procedure painful?
Most patients report minimal discomfort due to local anesthesia.
How long does the procedure take?
The procedure typically takes about 1 hour.
