Overview of CPT Code 22645:posterior-spinal-fusion-single-level

Overview of CPT Code 22645:posterior-spinal-fusion-single-level

CPT Code 22645 refers to a surgical procedure known as posterior spinal fusion at a single level, which is performed to stabilize the spine by fusing two or more vertebrae together.

When CPT Code 22645 is Used?

This procedure is indicated in various clinical scenarios.

• Severe spinal instability due to trauma or degenerative disease.
• Spondylolisthesis where one vertebra slips over another.
• Chronic back pain due to spinal deformities.
• Failed conservative treatment for spinal conditions.

Symptoms Indicating This Procedure

Patients may report several symptoms that lead to the consideration of this procedure.

• Persistent back pain that does not improve with conservative treatment.
• Numbness or weakness in the legs.
• Difficulty walking or maintaining balance.
• Limited range of motion in the spine.

Causes and Risk Factors

Several factors can contribute to the need for this procedure.

• Degenerative disc disease.
• Traumatic injuries to the spine.
• Congenital spinal deformities.
• Previous spinal surgeries that have failed.

Diagnostic Tests Before Procedure

Several diagnostic tests are typically performed to assess the condition of the spine.

• X-rays to evaluate spinal alignment and stability.
• MRI scans to assess soft tissue and nerve involvement.
• CT scans for detailed imaging of the bony structures.
• Electromyography (EMG) to evaluate nerve function.

Procedure Description

The procedure involves several key steps to ensure successful spinal fusion.

• Administer anesthesia to the patient.
• Make an incision along the back to access the spine.
• Remove any damaged disc material or bone spurs.
• Position bone graft material between the vertebrae to promote fusion.
• Use screws and rods to stabilize the spine during healing.
• Close the incision with sutures or staples.

Preparation for the Procedure

Patients should follow specific guidelines to prepare for surgery.

• Avoid eating or drinking after midnight before the surgery.
• Discuss all medications with the surgeon, including over-the-counter drugs.
• Arrange for transportation to and from the hospital.
• Follow any pre-operative instructions provided by the healthcare team.

Recovery and Aftercare

Post-operative recovery is crucial for successful outcomes.

• Stay in the hospital for 1-3 days for monitoring.
• Gradually increase activity levels as advised by the surgeon.
• Follow a prescribed pain management plan.
• Attend physical therapy sessions to aid recovery.

Possible Complications

As with any surgical procedure, there are potential risks involved.

• Infection at the surgical site.
• Nerve damage leading to weakness or numbness.
• Non-union of the vertebrae, requiring further surgery.
• Blood clots in the legs or lungs.

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Post-Procedure Follow-Up

Regular follow-up is essential to monitor recovery.

• Initial follow-up appointment within 2 weeks post-surgery.
• Subsequent visits at 6 weeks, 3 months, and 6 months.
• X-rays may be taken to assess spinal fusion progress.

Alternative Treatments

There are non-surgical options available for managing spinal conditions.

• Physical therapy to strengthen back muscles.
• Chiropractic care for spinal alignment.
• Pain management techniques including medications and injections.
• Lifestyle modifications such as weight loss and exercise.

Home Care Tips

Patients can take steps at home to aid recovery.

• Keep the surgical site clean and dry.
• Avoid heavy lifting and twisting movements.
• Use ice packs to reduce swelling and pain.
• Follow the prescribed exercise regimen from the physical therapist.

Patient Education & Prevention

Understanding the condition can help prevent recurrence.

• Maintain a healthy weight to reduce spinal stress.
• Engage in regular low-impact exercise to strengthen back muscles.
• Practice good posture to minimize strain on the spine.
• Avoid smoking, as it can impede healing.

Billing and Coding Information

CPT Code: 22645

Category: Surgery

Common Modifiers:

• 50 - Bilateral procedure
• 59 - Distinct procedural service

Average Cost and Insurance Coverage

Costs can vary based on several factors.

• Average cost ranges from $30,000 to $60,000.
• Insurance typically covers the procedure if deemed medically necessary.
• Out-of-pocket costs depend on the patient's insurance plan.

Related CPT Codes

• 22630 - Posterior Lumbar Interbody Fusion
• 22632 - Spinal Fusion, Posterior or Lateral Approach, Single Level
• 22633 - Spinal Fusion, Posterior Interbody
• 22640 - 'Spinal fusion, posterior or posterolateral technique, single level'