Overview of CPT Code 22335:'Percutaneous vertebroplasty, lumbar'

Overview of CPT Code 22335:'Percutaneous vertebroplasty, lumbar'

Percutaneous vertebroplasty is a minimally invasive procedure used to treat vertebral compression fractures in the lumbar spine. It involves the injection of a bone cement into the fractured vertebra to stabilize it and alleviate pain.

When CPT Code 22335 is Used?

This procedure is indicated in specific clinical scenarios.

• Patients with painful vertebral compression fractures due to osteoporosis.
• Fractures resulting from trauma or malignancy.
• Patients who have not responded to conservative treatments such as pain medication or physical therapy.

Symptoms Indicating This Procedure

Patients typically report various symptoms that may lead to this procedure.

• Severe back pain localized to the fracture site.
• Pain that worsens with movement or standing.
• Limited mobility due to pain.
• 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.
• Age-related bone density loss.
• Previous history of vertebral fractures.
• Certain cancers that metastasize to the spine.

Diagnostic Tests Before Procedure

Several diagnostic tests are performed 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 vertebrae.

Procedure Description

The procedure is performed under local anesthesia and sedation.

• The patient is positioned comfortably, usually lying on their stomach.
• A small incision is made in the skin over the affected vertebra.
• A needle is inserted through the incision and guided into the fractured vertebra using fluoroscopic imaging.
• Bone cement is injected into the vertebra to stabilize it.
• The needle is removed, and the incision is closed with a bandage.

Preparation for the Procedure

Proper preparation is essential for a successful procedure.

• Patients should inform their doctor about all medications and supplements they are taking.
• Fasting for several hours before the procedure may be required.
• Arranging for someone to drive them home post-procedure.

Recovery and Aftercare

Recovery typically involves monitoring and care at home.

• Patients can usually go home the same day.
• Resting and avoiding heavy lifting for a few days is recommended.
• Pain relief medications may be prescribed.
• Follow-up appointments to monitor healing and pain levels.

Possible Complications

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

• Infection at the injection site.
• Bleeding or hematoma formation.
• Allergic reaction to the bone cement.
• Potential for cement leakage into surrounding tissues.

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Post-Procedure Follow-Up

Follow-up care is crucial for assessing recovery.

• Initial follow-up within one week to assess pain relief and healing.
• Additional follow-ups at one month and three months post-procedure.
• Long-term monitoring for any recurrence of symptoms.

Alternative Treatments

There are several non-surgical options available.

• Physical therapy to strengthen back muscles.
• Pain management with medications.
• Bracing to support the spine.
• Injections of corticosteroids to reduce inflammation.

Home Care Tips

Patients can take steps at home to aid recovery.

• Apply ice packs to the back to reduce swelling.
• Engage in gentle stretching and walking as tolerated.
• Maintain a healthy diet to support bone health.

Patient Education & Prevention

Education on prevention can help avoid future fractures.

• Engage in weight-bearing exercises to strengthen bones.
• Ensure adequate intake of calcium and vitamin D.
• Avoid smoking and limit alcohol consumption.

Billing and Coding Information

CPT Code: 22335

Category: Surgical Procedures

Common Modifiers:

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

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.
• Patients should verify coverage with their insurance provider.

Related CPT Codes

• 22510 - 'Injection of facet joint or sacroiliac joint'
• 22511 - Percutaneous vertebroplasty, lumbar