Overview of CPT Code 22356: Percutaneous vertebroplasty, lumbar

Overview of CPT Code 22356: 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 22356 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, which weakens bones and increases fracture risk.
• Age-related degeneration of the spine.
• Certain cancers that may weaken vertebrae.
• Previous spinal injuries or fractures.

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 local anesthetic is applied to the skin over the affected vertebra.
• A small incision is made, and a needle is 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.

• 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 after the procedure.

Recovery and Aftercare

Recovery is generally quick, but care is needed.

• Rest for the first 24 hours after the procedure.
• Gradually resume normal activities as tolerated.
• Follow up with your doctor for pain management and monitoring.
• Keep the incision site clean and dry.

Possible Complications

While generally safe, there are potential risks involved.

• Infection at the injection site.
• Bleeding or hematoma formation.
• Nerve damage leading to weakness or numbness.
• Cement leakage into surrounding tissues.

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Post-Procedure Follow-Up

Follow-up care is crucial for monitoring recovery.

• Schedule a follow-up appointment within a week after the procedure.
• Monitor pain levels and report any unusual symptoms.
• Regular check-ups to assess the healing process.

Alternative Treatments

There are non-surgical options available for managing vertebral fractures.

• Physical therapy to strengthen back muscles.
• Pain management with medications.
• Bracing to support the spine.
• Vertebral augmentation techniques like kyphoplasty.

Home Care Tips

Simple tips can aid in recovery at home.

• Use ice packs to reduce swelling and pain.
• Engage in gentle stretching and walking as tolerated.
• Avoid heavy lifting and twisting movements.

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.
• Regular screenings for osteoporosis, especially in older adults.

Billing and Coding Information

CPT Code: 22356

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.

Related CPT Codes

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