Overview of CPT Code 22804:posterior-spinal-fusion-posterior-approach

Overview of CPT Code 22804:posterior-spinal-fusion-posterior-approach

CPT Code 22804 refers to the surgical procedure known as posterior spinal fusion, which is performed through the back to stabilize the spine. This procedure is typically indicated for patients with spinal instability or deformities.

When CPT Code 22804 is Used?

This procedure is appropriate in various clinical scenarios.

• Severe spinal instability due to trauma or degenerative disease.
• Scoliosis or other spinal deformities requiring correction.
• Failed conservative treatment for back pain or instability.
• Tumors affecting spinal stability.

Symptoms Indicating This Procedure

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

• Chronic back pain that does not improve with conservative treatment.
• Numbness or weakness in the legs.
• Difficulty walking or maintaining balance.
• Visible spinal deformity.

Causes and Risk Factors

Several factors can contribute to the need for posterior spinal fusion.

• Degenerative disc disease.
• Spinal fractures from trauma.
• Congenital spinal deformities.
• Tumors affecting the spine.

Diagnostic Tests Before Procedure

Several diagnostic tests are performed to assess the need for surgery.

• X-rays to evaluate spinal alignment.
• MRI to assess soft tissue and nerve involvement.
• CT scans for detailed bone structure analysis.
• Electromyography (EMG) to evaluate 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 along the back to access the spine.
• Damaged or unstable vertebrae are identified.
• Bone graft material is placed to promote fusion.
• Metal rods and screws may be used to stabilize the spine.
• 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 blood thinners.
• 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.

• Hospital stay of 1-3 days for monitoring.
• Gradual return to normal activities over several weeks.
• Physical therapy to aid recovery and strengthen the back.
• 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 spine where fusion does not occur.
• Blood clots in the legs or lungs.

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Post-Procedure Follow-Up

Regular follow-up is essential for monitoring 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 alignment and fusion.

Alternative Treatments

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

• Physical therapy to strengthen back muscles.
• Chiropractic care for spinal alignment.
• Pain management techniques including injections.
• Medications for pain relief and inflammation.

Home Care Tips

Patients can take steps at home to aid recovery.

• Follow prescribed pain management regimen.
• Engage in light activities as tolerated.
• Avoid heavy lifting and twisting motions.
• 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.
• Engage in regular exercise to strengthen back muscles.
• Practice good posture to support spinal health.
• Avoid smoking, which can impede healing.

Billing and Coding Information

CPT Code: 22804

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 $60,000.
• Insurance typically covers medically necessary procedures.
• Out-of-pocket costs depend on the insurance plan.

Related CPT Codes

• 22630 - Posterior Lumbar Interbody Fusion
• 22633 - Spinal Fusion, Posterior Interbody