Overview of CPT Code 22844: Posterior spinal fusion, instrumented

Overview of CPT Code 22844: Posterior spinal fusion, instrumented

CPT Code 22844 refers to a surgical procedure known as posterior spinal fusion with instrumentation, which is performed to stabilize the spine by fusing two or more vertebrae together using metal rods and screws.

When CPT Code 22844 is Used?

This procedure is indicated in various clinical scenarios.

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

Symptoms Indicating This Procedure

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

• Chronic back pain that does not improve with conservative treatment.
• Nerve pain radiating down 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.
• Previous spinal surgeries leading to instability.

Diagnostic Tests Before Procedure

A variety of diagnostic tests are utilized to assess the condition of the spine.

• X-rays to evaluate spinal alignment and stability.
• MRI to assess soft tissue and nerve involvement.
• CT scans for detailed imaging of bony structures.
• Electromyography (EMG) to evaluate nerve function.

Procedure Description

The surgical procedure involves several key steps.

• Anesthesia is administered to ensure patient comfort.
• An incision is made along the back to access the spine.
• The affected vertebrae are prepared for fusion by removing any damaged tissue.
• Metal rods and screws are placed to stabilize the spine.
• Bone graft material is applied to promote fusion between vertebrae.
• 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 is crucial for successful outcomes.

• Hospital stay typically lasts 1-3 days post-surgery.
• Pain management with prescribed medications.
• Physical therapy may begin shortly after surgery.
• Follow-up appointments to monitor healing and spinal 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 weakness or numbness.
• Non-union of the vertebrae despite fusion.

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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.

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 inflammation and pain relief.

Home Care Tips

Patients can take steps at home to aid recovery.

• Follow prescribed medication schedules for pain management.
• 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: 22844

Category: Surgical Procedures

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 $30,000 to $80,000.
• Insurance typically covers the procedure if medically necessary.
• Out-of-pocket costs depend on the insurance plan.

Related CPT Codes

• 22840 - Posterior spinal fusion, posterior approach, single level
• 22842 - Posterior spinal fusion, additional level
• 22630 - Posterior Lumbar Interbody Fusion
• 22633 - Spinal Fusion, Posterior Interbody
• 22848 - Insertion of interbody fusion device, lumbar