Overview of CPT Code 21255: Injection of bone cement into vertebral body

Overview of CPT Code 21255: Injection of bone cement into vertebral body

CPT Code 21255 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 21255 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 report various symptoms that lead to the consideration of this procedure.

• Severe back pain that worsens with movement.
• Loss of height or stooped posture.
• Numbness or tingling 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 may be performed to confirm the need for this procedure.

• X-rays to visualize the fracture.
• MRI to assess the extent of the injury.
• CT scans for detailed imaging of the vertebrae.
• Bone density tests to evaluate osteoporosis.

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 in the skin over the affected vertebra.
• 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 incision is closed.

Preparation for the Procedure

Proper preparation is essential for a successful outcome.

• Discuss any medications with your doctor, especially blood thinners.
• Avoid eating or drinking for several hours before the procedure.
• Arrange for someone to drive you home post-procedure.
• Wear comfortable clothing and avoid jewelry.

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 and assessment.
• Keep the incision site clean and dry.

Possible Complications

While generally safe, there are potential risks associated with the procedure.

• Infection at the injection site.
• Allergic reaction to the bone cement.
• Increased pain or discomfort.
• Potential 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 healing.
• Further evaluations at one month and three months post-procedure.
• Ongoing monitoring for any signs of 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 and pain.
• Engage in gentle stretching exercises as advised.
• Maintain a healthy diet rich in calcium and vitamin D.
• Stay hydrated and avoid heavy lifting.

Patient Education & Prevention

Education is key to preventing future issues.

• Understand the importance of bone health and osteoporosis management.
• Engage in weight-bearing exercises to strengthen bones.
• Regularly monitor bone density as recommended by your doctor.
• Avoid smoking and limit alcohol consumption.

Billing and Coding Information

CPT Code: 21255

Category: Surgical Procedures

Common Modifiers:

• -50
• -LT
• -RT

Average Cost and Insurance Coverage

Costs can vary based on location and insurance.

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

References and Sources

• Vertebral Compression Fractures
• Kyphoplasty and Vertebroplasty