Overview of CPT Code 22360:'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 22360 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 and difficulty performing daily activities.
- 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.
- Trauma or injury to the spine.
- Certain cancers that metastasize to the vertebrae.
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 mixed and 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 transportation home after the procedure is advised.
Recovery and Aftercare
Post-procedure care is crucial for recovery.
- Patients can typically return home the same day.
- Resting and avoiding strenuous activities for a few days is recommended.
- Pain management may include prescribed medications.
- Follow-up appointments are necessary to monitor healing.
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 or worsening of symptoms.
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Post-Procedure Follow-Up
Follow-up care is important to ensure proper healing.
- Initial follow-up within one week to assess pain relief and recovery.
- Additional follow-ups at one month and three months post-procedure.
- Long-term monitoring may be necessary for underlying conditions.
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.
- Avoid heavy lifting and twisting movements.
Patient Education & Prevention
Education on prevention can help reduce recurrence.
- Engage in weight-bearing exercises to strengthen bones.
- Ensure adequate intake of calcium and vitamin D.
- Avoid smoking and excessive alcohol consumption.
- Regular screenings for osteoporosis in at-risk populations.
Billing and Coding Information
CPT Code: 22360
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.
- The average cost ranges from $5,000 to $15,000.
- Most insurance plans cover the procedure if deemed medically necessary.
- Patients should verify coverage with their insurance provider.
Related CPT Codes
Frequently Asked Questions (FAQs)
What is percutaneous vertebroplasty?
It is a minimally invasive procedure to treat vertebral compression fractures.
How long does the procedure take?
The procedure typically takes about 1 to 2 hours.
Will I need to stay overnight?
Most patients can go home the same day after the procedure.
What is the recovery time?
Recovery varies, but many patients feel relief within a few days.
