Overview of CPT Code 22847:posterior-spinal-fusion-interbody-technique

Overview of CPT Code 22847:posterior-spinal-fusion-interbody-technique

CPT Code 22847 refers to the surgical procedure known as posterior spinal fusion using an interbody technique. This procedure is performed to stabilize the spine by fusing two or more vertebrae together, often to alleviate pain and restore function.

When CPT Code 22847 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 disc degeneration.
• Spinal deformities such as scoliosis.
• Failed conservative treatment for spinal conditions.

Symptoms Indicating This Procedure

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

• Persistent back pain that does not improve with conservative treatment.
• Numbness or weakness in the legs.
• Difficulty walking or maintaining balance.
• Limited range of motion in the spine.
• Pain radiating down the legs (sciatica).

Causes and Risk Factors

Several factors can contribute to the need for this procedure.

• Degenerative disc disease.
• Traumatic injuries to the spine.
• Genetic predisposition to spinal disorders.
• Obesity, which increases stress on the spine.
• Previous spinal surgeries that may have failed.

Diagnostic Tests Before Procedure

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

• X-rays to evaluate spinal alignment and stability.
• MRI scans to visualize soft tissues and discs.
• CT scans for detailed images of the spine.
• Electromyography (EMG) to assess nerve function.
• Bone scans to detect any abnormalities.

Procedure Description

The procedure involves several key steps to ensure successful spinal fusion.

• Administer anesthesia to the patient.
• Make an incision along the back to access the spine.
• Remove any damaged disc material if necessary.
• Insert interbody devices (such as cages or grafts) between the vertebrae.
• Use bone graft material to promote fusion.
• Stabilize the spine with screws and rods.
• Close the incision with sutures or staples.

Preparation for the Procedure

Patients should follow specific guidelines to prepare for surgery.

• Consult with the surgeon about medications to avoid.
• Arrange for transportation to and from the hospital.
• Follow pre-operative fasting instructions.
• Discuss any allergies or medical conditions with the healthcare team.
• Complete any required pre-operative tests.

Recovery and Aftercare

Post-operative recovery is crucial for successful outcomes.

• Stay in the hospital for monitoring for 1-3 days.
• Follow a prescribed pain management plan.
• Engage in physical therapy as recommended.
• Avoid heavy lifting and twisting for several weeks.
• Attend follow-up appointments to monitor healing.

Possible Complications

As with any surgical procedure, 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.
• Persistent pain despite surgery.

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Post-Procedure Follow-Up

Regular follow-up is essential to ensure proper 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.
• Physical therapy progress should be evaluated.
• Monitor for any signs of complications.

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 medications.
• Epidural steroid injections for inflammation.
• Acupuncture for pain relief.

Home Care Tips

Patients can take steps at home to aid recovery.

• Follow the surgeon's post-operative instructions carefully.
• Keep the surgical site clean and dry.
• Use ice packs to reduce swelling.
• Engage in light activities as tolerated.
• Stay hydrated and maintain a healthy diet.

Patient Education & Prevention

Understanding the condition can help prevent recurrence.

• Maintain a healthy weight to reduce spinal stress.
• Engage in regular exercise to strengthen back muscles.
• Practice good posture to minimize strain.
• Avoid high-impact activities that may injure the spine.
• Stay informed about spinal health and seek early treatment for issues.

Billing and Coding Information

CPT Code: 22847

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 $30,000 to $60,000.
• Insurance typically covers medically necessary procedures.
• Out-of-pocket costs depend on the insurance plan.
• Pre-authorization may be required by some insurers.
• Check with the insurance provider for specific coverage details.

Related CPT Codes

• 22845 - Posterior spinal fusion, posterior approach, with instrumentation
• 22846 - Posterior lumbar interbody fusion, single level
• 22630 - Posterior Lumbar Interbody Fusion
• 22633 - Spinal Fusion, Posterior Interbody
• 22612 - Spinal Fusion, Posterior or Lateral Approach, Single Level
• 22630 - Posterior Lumbar Interbody Fusion