Overview of CPT Code 21245: Injection of bone cement into vertebral body
CPT Code 21245 refers to the procedure of injecting bone cement into a vertebral body, primarily used to treat vertebral compression fractures. This minimally invasive technique aims to stabilize the vertebrae and alleviate pain.
When CPT Code 21245 is Used?
This procedure is indicated in specific clinical scenarios.
- Vertebral compression fractures due to osteoporosis.
- Pathological fractures from tumors or malignancies.
- Severe back pain associated with vertebral instability.
Symptoms Indicating This Procedure
Patients may present with various symptoms that warrant this procedure.
- Severe localized back pain.
- Pain that worsens with movement or standing.
- Numbness or weakness in the legs.
- Difficulty walking or performing daily activities.
Causes and Risk Factors
Understanding the underlying causes and risk factors is crucial for prevention.
- Osteoporosis leading to weakened bones.
- Age-related bone density loss.
- Previous history of fractures.
- Certain cancers that affect bone health.
Diagnostic Tests Before Procedure
Several diagnostic tests help confirm the need for this procedure.
- X-rays to visualize fractures.
- MRI to assess the extent of injury and surrounding tissues.
- CT scans for detailed imaging of the vertebrae.
Procedure Description
The procedure involves several key steps to ensure safety and effectiveness.
- Patient is positioned comfortably, often lying on their stomach.
- Local anesthesia is administered to numb the area.
- A small incision is made to insert a needle into the vertebral body.
- Bone cement is injected into the vertebra to stabilize it.
- The needle is removed, and the incision is closed.
Preparation for the Procedure
Proper preparation is essential for a successful outcome.
- Discuss any medications with your doctor, especially blood thinners.
- Arrange for transportation home post-procedure.
- Follow fasting instructions if sedation is planned.
- Wear comfortable clothing on the day of the procedure.
Recovery and Aftercare
Post-procedure care is vital for optimal recovery.
- Rest for the first 24 hours after the procedure.
- Gradually resume normal activities as tolerated.
- Follow up with your doctor for pain management.
- Monitor for any signs of complications, such as increased pain or swelling.
Possible Complications
While generally safe, there are potential risks associated with the procedure.
- Infection at the injection site.
- Allergic reaction to the bone cement.
- Nerve damage leading to weakness or numbness.
- Leakage of cement into surrounding tissues.
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Post-Procedure Follow-Up
Regular follow-up is important to monitor recovery.
- Initial follow-up within one week to assess pain and mobility.
- Further evaluations at one month and three months post-procedure.
- Ongoing monitoring for any late-onset complications.
Alternative Treatments
There are several non-surgical options available.
- Physical therapy to strengthen back muscles.
- Pain management with medications.
- Bracing to support the spine.
- Vertebroplasty or kyphoplasty as alternative surgical options.
Home Care Tips
Simple home care can aid in recovery.
- Apply ice packs to reduce swelling.
- Take prescribed medications as directed.
- Engage in gentle stretching exercises as advised.
- Maintain a healthy diet to support bone health.
Patient Education & Prevention
Education is key to preventing future issues.
- Maintain a balanced diet rich in calcium and vitamin D.
- Engage in weight-bearing exercises to strengthen bones.
- Avoid smoking and limit alcohol consumption.
- Regular screenings for bone density, especially in at-risk populations.
Billing and Coding Information
CPT Code: 21245
Category: Surgical Procedures
Common Modifiers:
- 50 (bilateral procedure)
- LT (left side)
- RT (right side)
Average Cost and Insurance Coverage
Understanding costs and insurance can help with planning.
- Average cost ranges from $5,000 to $15,000 depending on facility and location.
- Most insurance plans cover the procedure if deemed medically necessary.
- Out-of-pocket costs may vary based on deductible and co-insurance.
Related CPT Codes
- 20610 - 'Arthrocentesis, aspiration of joint'
- 20605 - 'Arthrocentesis, aspiration, and/or injection into a major joint or bursa'
- 20611 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa.
References and Sources
Frequently Asked Questions (FAQs)
What is the purpose of the injection?
The injection aims to stabilize the vertebra and relieve pain.
Is the procedure painful?
Most patients report minimal discomfort during the procedure due to anesthesia.
How long does recovery take?
Recovery varies, but many patients return to normal activities within a few days.
Are there any restrictions after the procedure?
Patients are advised to avoid heavy lifting and strenuous activities for a short period.
