Overview of CPT Code 22840: Posterior spinal fusion, posterior approach, single level

Overview of CPT Code 22840: Posterior spinal fusion, posterior approach, single level

CPT Code 22840 refers to a surgical procedure known as posterior spinal fusion, which is performed through the back to stabilize the spine at a single level. This procedure is typically indicated for patients with spinal instability or deformities.

When CPT Code 22840 is Used?

This procedure is appropriate in various clinical scenarios.

• Spondylolisthesis causing instability
• Degenerative disc disease with significant pain
• Spinal fractures requiring stabilization
• Post-laminectomy instability
• Spinal deformities such as scoliosis

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
• Nerve pain radiating to the legs
• Weakness or numbness in the legs
• Difficulty walking or maintaining balance
• Visible spinal deformity

Causes and Risk Factors

Several factors can contribute to the need for this procedure.

• Age-related degeneration of spinal structures
• Trauma or injury to the spine
• Genetic predisposition to spinal disorders
• Previous spinal surgeries
• Obesity increasing spinal stress

Diagnostic Tests Before Procedure

Several diagnostic tests are typically 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
• Physical examination to assess symptoms and mobility

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.
• The affected vertebrae are exposed and any damaged tissue is removed.
• Bone graft material is placed between the vertebrae to promote fusion.
• 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.
• Consider pre-surgery physical therapy if recommended.

Recovery and Aftercare

Post-operative recovery is crucial for successful outcomes.

• Hospital stay of 1-3 days for monitoring.
• Gradual return to normal activities as advised by the surgeon.
• Pain management with prescribed medications.
• Physical therapy to regain strength and mobility.
• Regular follow-up appointments to monitor healing.

Possible Complications

As with any surgery, there are potential risks involved.

• Infection at the surgical site
• Blood clots in the legs
• Nerve damage leading to weakness or numbness
• Non-union of the bone graft
• Persistent pain despite surgery

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Post-Procedure Follow-Up

Follow-up care 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 and mobility.

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.
• 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.
• Keep the surgical site clean and dry.
• Avoid heavy lifting and strenuous activities.
• Engage in gentle walking to promote circulation.
• Attend all scheduled follow-up appointments.

Patient Education & Prevention

Understanding prevention can help avoid future issues.

• Maintain a healthy weight to reduce spinal stress.
• Engage in regular exercise to strengthen back muscles.
• Practice good posture to minimize strain on the spine.
• Avoid smoking, which can impede healing.
• Stay informed about spinal health and seek early treatment for issues.

Billing and Coding Information

CPT Code: 22840

Category: Surgery

Common Modifiers:

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

Average Cost and Insurance Coverage

Costs can vary based on several factors.

• Average cost ranges from $20,000 to $50,000.
• Insurance typically covers the procedure if deemed medically necessary.
• Out-of-pocket costs depend on the patient's insurance plan.

Related CPT Codes

• 22841 - Posterior spinal fusion, each additional segment
• 22630 - Posterior Lumbar Interbody Fusion
• 22633 - Spinal Fusion, Posterior Interbody
• 22842 - Posterior spinal fusion, additional level
• 22830 - Posterior spinal fusion, posterior approach