Overview of CPT Code 22655: Spinal Fusion, Posterior Interbody, Lumbar

Overview of CPT Code 22655: Spinal Fusion, Posterior Interbody, Lumbar

CPT Code 22655 refers to a surgical procedure known as spinal fusion, specifically performed through a posterior interbody approach in the lumbar region of the spine. This procedure aims to stabilize the spine by fusing two or more vertebrae together, often to alleviate pain and restore function.

When CPT Code 22655 is Used?

This procedure is indicated in various clinical scenarios.

• Severe degenerative disc disease causing chronic back pain.
• Spondylolisthesis resulting in instability of the spine.
• Spinal stenosis leading to nerve compression and pain.
• Failed conservative treatment for lumbar spine conditions.

Symptoms Indicating This Procedure

Patients may report several symptoms that suggest the need for this procedure.

• Chronic lower back pain that does not improve with conservative treatments.
• Radiating pain into the legs (sciatica).
• Numbness or weakness in the legs.
• Difficulty walking or standing for prolonged periods.

Causes and Risk Factors

Understanding the underlying causes and risk factors is crucial for prevention.

• Age-related degeneration of spinal discs.
• Trauma or injury to the spine.
• Genetic predisposition to spinal disorders.
• Obesity increasing stress on the spine.

Diagnostic Tests Before Procedure

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

• MRI to visualize soft tissue and nerve compression.
• CT scan for detailed images of the spine.
• X-rays to evaluate spinal alignment and degeneration.
• Electromyography (EMG) to assess nerve function.

Procedure Description

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

• Patient is placed under general anesthesia.
• An incision is made in the lower back to access the spine.
• The affected disc is removed to relieve pressure on nerves.
• Bone graft material is placed between the vertebrae to promote fusion.
• Instrumentation such as screws and rods may be used for stabilization.
• The incision is closed with sutures or staples.

Preparation for the Procedure

Proper preparation is essential for a successful outcome.

• Avoid eating or drinking after midnight before the surgery.
• Discuss all medications with your doctor, including over-the-counter drugs.
• Arrange for someone to drive you home post-surgery.
• Follow any specific instructions provided by your healthcare team.

Recovery and Aftercare

Recovery can vary, but certain guidelines are generally followed.

• Hospital stay of 1-3 days post-surgery.
• Gradual return to normal activities over several weeks.
• Physical therapy may be recommended to aid recovery.
• Pain management with prescribed medications.

Possible Complications

As with any surgery, 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

Follow-up care is crucial for monitoring recovery.

• Initial follow-up appointment within 2 weeks post-surgery.
• Regular check-ups every 4-6 weeks for the first few months.
• Imaging studies may be repeated to assess 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 injections.
• Medications such as NSAIDs for pain relief.

Home Care Tips

Patients can take several steps to aid their recovery at home.

• Follow prescribed pain management regimen.
• Engage in light activities as tolerated, avoiding heavy lifting.
• Maintain a healthy diet to support healing.
• Keep the surgical site clean and dry.

Patient Education & Prevention

Education is key to preventing future issues.

• Maintain a healthy weight to reduce spinal stress.
• Practice good posture to support spinal health.
• Engage in regular exercise to strengthen back muscles.
• Avoid smoking, which can impede healing.

Billing and Coding Information

CPT Code: 22655

Category: Surgical Procedures

Common Modifiers:

• 50 (bilateral procedure)
• RT (right side)
• LT (left side)

Average Cost and Insurance Coverage

Costs can vary widely based on several factors.

• Average cost ranges from $30,000 to $80,000.
• Insurance typically covers the procedure if deemed medically necessary.
• Out-of-pocket costs depend on individual insurance plans.

Related CPT Codes

• 22630 - Posterior Lumbar Interbody Fusion
• 22632 - Spinal Fusion, Posterior or Lateral Approach, Single Level
• 22633 - Spinal Fusion, Posterior Interbody
• 22840 - Posterior spinal fusion, posterior approach, single level