Overview of CPT Code 22837:posterior-spinal-fusion-posterior-approach-single-level

Overview of CPT Code 22837:posterior-spinal-fusion-posterior-approach-single-level

CPT Code 22837 refers to a surgical procedure known as posterior spinal fusion, performed through a posterior approach at a single level of the spine. This procedure is typically indicated for patients with spinal instability or deformity, aiming to stabilize the spine and alleviate pain.

When CPT Code 22837 is Used?

This procedure is appropriate in various clinical scenarios.

• Severe spinal instability due to trauma or degenerative disease.
• Spondylolisthesis causing significant pain or neurological symptoms.
• Spinal deformities such as scoliosis that require correction.
• Failed conservative treatments for chronic back pain.

Symptoms Indicating This Procedure

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

• Chronic back pain that does not improve with conservative treatment.
• Radiating pain into the legs or arms.
• Numbness or weakness in the extremities.
• Difficulty walking or maintaining balance.

Causes and Risk Factors

Several factors can contribute to the conditions necessitating this procedure.

• Degenerative disc disease.
• Traumatic injuries to the spine.
• Congenital spinal deformities.
• Previous spinal surgeries leading to instability.

Diagnostic Tests Before Procedure

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

• MRI to evaluate soft tissue and nerve involvement.
• CT scans for detailed bone structure assessment.
• X-rays to determine spinal alignment and stability.
• Electromyography (EMG) to assess nerve function.

Procedure Description

The surgical procedure involves several key steps.

• Patient is placed under general anesthesia.
• A posterior incision is made along the spine.
• Muscle and tissue are carefully retracted to expose the vertebrae.
• Bone graft material is placed between the affected vertebrae.
• Instrumentation such as rods and screws 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.
• Follow any pre-operative instructions provided by the healthcare team.

Recovery and Aftercare

Post-operative recovery involves several important aspects.

• Hospital stay typically lasts 1-3 days post-surgery.
• Pain management with prescribed medications.
• Gradual return to normal activities as advised by the surgeon.
• Physical therapy may be recommended 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.
• Blood clots in the legs or lungs.
• Non-union of the bone graft.

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Post-Procedure Follow-Up

Regular follow-up is essential for monitoring recovery.

• Initial follow-up appointment within 2-4 weeks post-surgery.
• X-rays may be taken to assess healing.
• Ongoing assessments every few months for the first year.
• Long-term follow-up as needed based on recovery progress.

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 such as NSAIDs for pain relief.

Home Care Tips

Patients can take steps at home to aid recovery.

• Keep the surgical site clean and dry.
• Follow prescribed medication schedules.
• Engage in light activities as tolerated.
• Avoid heavy lifting and twisting motions.

Patient Education & Prevention

Understanding how to prevent future issues is crucial.

• 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: 22837

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 $20,000 to $50,000.
• Insurance typically covers medically necessary procedures.
• Out-of-pocket costs depend on individual insurance plans.

Related CPT Codes

• 22612 - Spinal Fusion, Posterior or Lateral Approach, Single Level
• 22630 - Posterior Lumbar Interbody Fusion
• 22830 - Posterior spinal fusion, posterior approach
• 22851 - Insertion of intervertebral biomechanical device
• 22551 - Injection of facet joint or sacroiliac joint