Overview of CPT Code 22845: Posterior spinal fusion, posterior approach, with instrumentation

Overview of CPT Code 22845: Posterior spinal fusion, posterior approach, with instrumentation

CPT Code 22845 refers to a surgical procedure involving the fusion of the spine through a posterior approach, utilizing instrumentation to stabilize the vertebrae.

When CPT Code 22845 is Used?

This procedure is indicated in various clinical scenarios.

• Severe spinal instability due to trauma or degenerative disease.
• Spondylolisthesis where one vertebra slips over another.
• Chronic back pain due to spinal deformities.
• Failed conservative treatment for spinal conditions.

Symptoms Indicating This Procedure

Patients may present with several symptoms that warrant this surgical intervention.

• Persistent back pain that does not improve with conservative treatment.
• Nerve pain radiating to the legs.
• Muscle weakness or numbness in the lower extremities.
• Difficulty walking or maintaining balance.

Causes and Risk Factors

Several factors can contribute to the need for this procedure.

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

Diagnostic Tests Before Procedure

Several diagnostic tests are performed to assess the condition of the spine.

• X-rays to evaluate spinal alignment and stability.
• MRI scans to assess soft tissue and nerve involvement.
• CT scans for detailed imaging of bony structures.
• 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.
• A posterior incision is made along the spine.
• Muscle and tissue are carefully retracted to expose the vertebrae.
• Instrumentation, such as rods and screws, is placed to stabilize the spine.
• Bone graft material is applied to promote fusion between vertebrae.
• Incision is closed in layers, and sterile dressings are applied.

Preparation for the Procedure

Proper preparation is essential for a successful surgery.

• Complete pre-operative assessments and imaging.
• Discuss medications with the healthcare provider, especially blood thinners.
• Avoid eating or drinking after midnight before the surgery.
• Arrange for post-operative transportation and care.

Recovery and Aftercare

Recovery involves careful monitoring and care.

• Hospital stay of 1-3 days post-surgery.
• Gradual return to normal activities over several weeks.
• Physical therapy to strengthen back muscles.
• 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 vertebrae.
• Blood clots in the legs or lungs.

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Post-Procedure Follow-Up

Follow-up care is crucial for monitoring recovery.

• Initial follow-up appointment within 2 weeks post-surgery.
• Regular check-ups every 4-6 weeks for the first few months.
• Imaging studies to assess fusion progress.

Alternative Treatments

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

• 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 medication regimen 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: 22845

Category: Surgical Procedures

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 the procedure if deemed medically necessary.
• Out-of-pocket costs depend on the insurance plan and deductible.

Related CPT Codes

• 22840 - Posterior spinal fusion, posterior approach, single level
• 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