Overview of CPT Code 22849:posterior-spinal-fusion-posterior-approach

Overview of CPT Code 22849:posterior-spinal-fusion-posterior-approach

CPT Code 22849 refers to a surgical procedure known as posterior spinal fusion, which is performed through the posterior approach to stabilize the spine by fusing two or more vertebrae together.

When CPT Code 22849 is Used?

This procedure is indicated in various clinical scenarios.

• Severe spinal instability due to trauma or degenerative diseases.
• Spondylolisthesis where one vertebra slips over another.
• Spinal deformities such as scoliosis.
• Chronic back pain due to degenerative disc disease.
• 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.
• Visible spinal deformity.
• Limited range of motion in the back.

Causes and Risk Factors

Several factors can contribute to the need for posterior spinal fusion.

• Traumatic injuries to the spine.
• Degenerative disc disease.
• Congenital spinal deformities.
• Previous spinal surgeries that have failed.
• Obesity and sedentary lifestyle.

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 assess soft tissue and nerve involvement.
• CT scans for detailed imaging of the 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.
• An incision is made along the back to access the spine.
• The affected vertebrae are prepared for fusion by removing any damaged disc material.
• Bone graft material is placed between the vertebrae to promote fusion.
• Instrumentation such as rods and screws may be used to stabilize the spine.
• The incision is closed with sutures or staples.

Preparation for the Procedure

Proper preparation is essential for a successful surgery.

• Discuss any medications with your doctor, especially blood thinners.
• Avoid eating or drinking after midnight before the surgery.
• Arrange for transportation to and from the hospital.
• Follow any specific instructions provided by your healthcare team.

Recovery and Aftercare

Recovery from posterior spinal fusion can vary among patients.

• Hospital stay typically lasts 2 to 4 days post-surgery.
• Gradual return to normal activities over several weeks.
• Physical therapy may be recommended to aid recovery.
• Pain management with prescribed medications.
• Regular follow-up appointments to monitor healing.

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.
• Complications from anesthesia.

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Post-Procedure Follow-Up

Follow-up care is crucial for monitoring recovery.

• Initial follow-up within 2 weeks post-surgery.
• Subsequent visits at 6 weeks, 3 months, and 6 months.
• Regular imaging studies to assess fusion progress.
• Ongoing evaluation of pain and mobility.

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 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 movements as advised by your doctor.
• Stay hydrated and maintain a balanced diet.

Patient Education & Prevention

Education is key to preventing 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: 22849

Category: Surgical Procedures

Common Modifiers:

• 50 - Bilateral procedure
• 59 - Distinct procedural service

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 deemed medically necessary.
• Out-of-pocket costs depend on individual insurance plans.

Related CPT Codes

• 22840 - Posterior spinal fusion, posterior approach, single level
• 22842 - Posterior spinal fusion, additional level
• 22612 - Spinal Fusion, Posterior or Lateral Approach, Single Level
• 22630 - Posterior Lumbar Interbody Fusion
• 22851 - Insertion of intervertebral biomechanical device