Overview of CPT Code 21249: Injection of bone cement into the vertebral body

Overview of CPT Code 21249: Injection of bone cement into the vertebral body

CPT Code 21249 refers to the procedure of injecting bone cement into the vertebral body, primarily used to treat vertebral compression fractures.

When CPT Code 21249 is Used?

This procedure is indicated in specific clinical scenarios.

• Vertebral compression fractures due to osteoporosis.
• Pain management in patients with metastatic cancer affecting the spine.
• Pathological fractures in patients with bone lesions.

Symptoms Indicating This Procedure

Patients may report various symptoms that lead to this procedure.

• Severe back pain that worsens with movement.
• Loss of height or stooped posture.
• Neurological symptoms such as numbness or weakness in the legs.

Causes and Risk Factors

Understanding the causes and risk factors is crucial for prevention.

• Osteoporosis leading to weakened bones.
• Age-related bone density loss.
• Previous history of fractures.

Diagnostic Tests Before Procedure

Several diagnostic tests help determine the need for this procedure.

• X-rays to visualize fractures.
• MRI to assess the extent of spinal injury.
• CT scans for detailed imaging of the vertebrae.

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 vertebral body 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 provided by your healthcare team.

Recovery and Aftercare

Post-procedure care is vital 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.

• Infection at the injection site.
• Allergic reaction to the bone cement.
• Nerve damage or increased pain.

Secure, compliant, and built for trust

HIPAA-compliant and designed with privacy in mind, your patient’s data is protected. Focus on care while we safeguard your information.

Learn more

Post-Procedure Follow-Up

Follow-up is important to monitor recovery.

• Schedule a follow-up appointment within 1-2 weeks.
• Monitor for any signs of complications.
• Discuss pain levels and functional improvement.

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.

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 check-ups to monitor bone health.

Billing and Coding Information

CPT Code: 21249

Category: Surgical Procedures

Common Modifiers:

• 50 - Bilateral procedure
• LT - Left side
• RT - Right side

Average Cost and Insurance Coverage

Costs can vary based on several factors.

• Average cost ranges from $5,000 to $15,000.
• Most insurance plans cover the procedure if deemed medically necessary.
• Check with your insurance provider for specific coverage details.

Related CPT Codes

• 20610 - 'Arthrocentesis, aspiration of joint'
• 20605 - 'Arthrocentesis, aspiration, and/or injection into a major joint or bursa'

References and Sources

• Vertebral Augmentation: A Review
• Management of Osteoporotic Vertebral Fractures