Overview of CPT Code 22846:posterior-lumbar-interbody-fusion-single-level

Overview of CPT Code 22846:posterior-lumbar-interbody-fusion-single-level

CPT Code 22846 refers to a surgical procedure known as posterior lumbar interbody fusion at a single level, which is performed to stabilize the spine and alleviate pain caused by degenerative disc disease or spinal instability.

When CPT Code 22846 is Used?

This procedure is indicated in specific clinical scenarios.

• Severe lower back pain due to degenerative disc disease.
• Spinal instability following trauma or surgery.
• Spondylolisthesis causing nerve compression.
• Failed conservative treatment options for back pain.

Symptoms Indicating This Procedure

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

• Chronic lower back pain that does not improve with conservative treatment.
• Radiating pain into the legs (sciatica).
• Numbness or weakness in the legs.
• Difficulty walking or standing for prolonged periods.

Causes and Risk Factors

Several factors can contribute to the need for this procedure.

• Age-related degeneration of spinal discs.
• Genetic predisposition to spinal disorders.
• Previous spinal injuries or surgeries.
• Obesity and sedentary lifestyle.

Diagnostic Tests Before Procedure

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

• MRI to visualize soft tissue and nerve compression.
• CT scan for detailed images of the spine.
• X-rays to assess spinal alignment and stability.
• Electromyography (EMG) to evaluate nerve function.

Procedure Description

The procedure involves several key steps to ensure successful fusion.

• Administer anesthesia to the patient.
• Make an incision in the lower back to access the spine.
• Remove the damaged disc material between the vertebrae.
• Insert a bone graft or interbody device to promote fusion.
• Stabilize the spine with screws and rods if necessary.
• Close the incision 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 current medications with the surgeon.
• 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.

• Stay in the hospital for 1-3 days for monitoring.
• Gradually increase activity levels as advised by the surgeon.
• Follow a prescribed pain management plan.
• Attend physical therapy sessions as recommended.

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 bone graft.
• 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.
• Imaging studies may be repeated to assess fusion progress.

Alternative Treatments

There are non-surgical options available for managing back pain.

• Physical therapy to strengthen back muscles.
• Chiropractic care for spinal alignment.
• Pain management techniques including medications.
• Epidural steroid injections to reduce inflammation.

Home Care Tips

Patients can take steps at home to aid recovery.

• Follow the prescribed exercise and rehabilitation program.
• Maintain a healthy diet to support healing.
• Avoid heavy lifting and twisting movements.
• Use ice or heat therapy for pain relief as needed.

Patient Education & Prevention

Understanding how to prevent future issues is important.

• Maintain a healthy weight to reduce spinal stress.
• Engage in regular exercise to strengthen core muscles.
• Practice good posture when sitting and standing.
• Avoid smoking, which can impede healing.

Billing and Coding Information

CPT Code: 22846

Category: Surgical Procedures

Common Modifiers:

• -50
• -LT
• -RT

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 medically necessary.
• Out-of-pocket costs depend on the insurance plan.

Related CPT Codes

• 22630 - Posterior Lumbar Interbody Fusion
• 22632 - Spinal Fusion, Posterior or Lateral Approach, Single Level
• 22842 - Posterior spinal fusion, additional level
• 22845 - Posterior spinal fusion, posterior approach, with instrumentation