Overview of CPT Code 22735: Spinal Fusion, Posterior Interbody, Lumbar

Overview of CPT Code 22735: Spinal Fusion, Posterior Interbody, Lumbar

CPT Code 22735 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 22735 is Used?

This procedure is indicated in various clinical scenarios.

• Severe degenerative disc disease causing significant pain.
• Spondylolisthesis resulting in instability of the spine.
• Spinal stenosis leading to nerve compression.
• Failed conservative treatment for lumbar spine conditions.
• Fractures or trauma affecting spinal stability.

Symptoms Indicating This Procedure

Patients may report a range of symptoms that suggest the need for this surgical intervention.

• 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.
• Loss of bladder or bowel control in severe cases.

Causes and Risk Factors

Several factors can contribute to the conditions necessitating this procedure.

• Age-related degeneration of spinal discs.
• Genetic predisposition to spinal disorders.
• Previous spinal injuries or trauma.
• Obesity increasing stress on the spine.
• Occupational hazards involving heavy lifting or repetitive motion.

Diagnostic Tests Before Procedure

A variety of diagnostic tests are utilized to assess the need for spinal fusion.

• MRI to visualize soft tissue and nerve compression.
• CT scans for detailed bone structure assessment.
• X-rays to evaluate spinal alignment and stability.
• Electromyography (EMG) to assess nerve function.
• Discography to determine the source of pain.

Procedure Description

The spinal fusion procedure involves several key steps.

• 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

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.
• Prepare a recovery area at home with necessary supplies.
• Follow any specific instructions provided by the healthcare team.

Recovery and Aftercare

Post-operative recovery is crucial for successful outcomes.

• Hospital stay may last 1-3 days depending on recovery.
• Pain management with prescribed medications.
• Gradual return to normal activities as advised by the surgeon.
• Physical therapy may be recommended to aid recovery.
• Follow-up appointments to monitor healing and spine stability.

Possible Complications

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

• Infection at the surgical site.
• Blood clots in the legs or lungs.
• Nerve damage leading to persistent pain or weakness.
• Non-union of the vertebrae requiring further surgery.
• Complications from anesthesia.

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Post-Procedure Follow-Up

Regular follow-up is essential for monitoring recovery.

• Initial follow-up within 2 weeks post-surgery.
• Subsequent visits at 6 weeks, 3 months, and 6 months.
• Imaging studies may be repeated to assess fusion progress.
• Ongoing evaluation of pain levels and functional improvement.

Alternative Treatments

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

• Physical therapy to strengthen back muscles.
• Chiropractic care for spinal alignment.
• Epidural steroid injections for pain relief.
• Medications such as NSAIDs for inflammation.
• Lifestyle modifications including weight loss and exercise.

Home Care Tips

Patients can take steps at home to aid recovery.

• Follow prescribed medication regimen for pain management.
• Engage in light activities as tolerated, avoiding heavy lifting.
• Use ice or heat packs to manage discomfort.
• Maintain a healthy diet to support healing.
• Keep follow-up appointments and communicate any concerns.

Patient Education & Prevention

Understanding the condition can help prevent recurrence.

• Learn proper body mechanics to avoid strain.
• Engage in regular exercise to strengthen the back.
• Maintain a healthy weight to reduce spinal stress.
• Avoid smoking, which can impede healing.
• Stay informed about spinal health and seek early treatment for issues.

Billing and Coding Information

CPT Code: 22735

Category: Surgery

Common Modifiers:

• 50 - Bilateral procedure
• RT - Right side
• LT - Left side

Average Cost and Insurance Coverage

Costs can vary based on several factors.

• Average cost ranges from $30,000 to $80,000.
• Insurance typically covers the procedure if medically necessary.
• Out-of-pocket costs depend on the insurance plan and deductible.
• Pre-authorization may be required by insurance providers.

Related CPT Codes

• 22630 - Posterior Lumbar Interbody Fusion
• 22633 - Spinal Fusion, Posterior Interbody
• 22612 - Spinal Fusion, Posterior or Lateral Approach, Single Level
• 22614 - Spinal Fusion, Posterior or Lateral Approach, Single Level
• 22840 - Posterior spinal fusion, posterior approach, single level