Overview of CPT Code 22355: 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 special bone cement into the fractured vertebra to stabilize it and alleviate pain.

When CPT Code 22355 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 nerves are affected.

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.
Trauma or injury to the spine.
Certain cancers that weaken bone structure.

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 vertebra.

Procedure Description

The procedure is performed under local anesthesia and imaging guidance.

The patient is positioned comfortably, usually lying on their stomach.
Local anesthesia is administered to numb the skin and underlying tissues.
A small incision is made in the skin over the affected vertebra.
A needle is carefully inserted into the vertebra using fluoroscopic guidance.
Bone cement is injected into the fractured 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.

Discuss any medications with your doctor, especially blood thinners.
Arrange for someone to drive you home after the procedure.
Follow any fasting instructions provided by your healthcare team.
Wear comfortable clothing on the day of the procedure.

Recovery and Aftercare

Post-procedure care is crucial 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.
Bleeding or hematoma formation.
Allergic reaction to the bone cement.
Nerve damage leading to weakness or numbness.

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Post-Procedure Follow-Up

Follow-up care is important to monitor recovery.

Schedule a follow-up appointment within 1-2 weeks post-procedure.
Monitor for any signs of complications such as increased pain or swelling.
Discuss pain management strategies and rehabilitation options.

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

Simple home care can aid in recovery.

Apply ice packs to the back to reduce swelling.
Take prescribed pain medications as directed.
Avoid heavy lifting or strenuous activities for a few weeks.
Engage in gentle stretching and walking as tolerated.

Patient Education & Prevention

Education is key to preventing future fractures.

Maintain a healthy diet rich in calcium and vitamin D.
Engage in weight-bearing exercises to strengthen bones.
Avoid smoking and limit alcohol consumption.
Regularly monitor bone density, especially if at risk.

Billing and Coding Information

CPT Code: 22355

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.

The average cost ranges from $5,000 to $15,000 depending on facility and location.
Most insurance plans cover the procedure if deemed medically necessary.
Check with your insurance provider for specific coverage details.