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Overview of CPT Code 21275: Injection of bone cement into vertebral body

Overview of CPT Code 21275: Injection of bone cement into vertebral body

CPT Code 21275 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 spine and alleviate pain.

When CPT Code 21275 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 fractures not responding to conservative treatment.

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 integrity.

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.

  • 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 vertebral body to stabilize it.
  • The needle is removed, and the site is bandaged.

Preparation for the Procedure

Proper preparation is essential for a successful outcome.

  • 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.
  • Monitor the injection site for signs of infection.

Possible Complications

While generally safe, there are potential risks involved.

  • Infection at the injection site.
  • Allergic reaction to the bone cement.
  • Increased pain or discomfort post-procedure.
  • Potential leakage of cement into surrounding tissues.
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Post-Procedure Follow-Up

Regular follow-up is important for monitoring recovery.

  • Initial follow-up within one week to assess pain and mobility.
  • Further evaluations at one month and three months post-procedure.
  • Ongoing assessments as needed based on recovery progress.

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 the injection site to reduce swelling.
  • Engage in gentle stretching and mobility exercises.
  • Stay hydrated and maintain a balanced diet for healing.

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: 21275

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.
  • Out-of-pocket costs depend on individual insurance plans and deductibles.

References and Sources

Frequently Asked Questions (FAQs)

What is the purpose of the injection?

The injection aims to stabilize the vertebra and relieve pain.

How long does the procedure take?

The procedure typically takes about 1 hour.

Will I need anesthesia?

Yes, local anesthesia is used to minimize discomfort.

What is the recovery time?

Most patients can resume normal activities within a few days.

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