Overview of CPT Code 22852: Posterior lumbar interbody fusion

Overview of CPT Code 22852: Posterior lumbar interbody fusion

CPT Code 22852 refers to the surgical procedure known as posterior lumbar interbody fusion, which involves the removal of intervertebral discs and the fusion of adjacent vertebrae in the lumbar spine to alleviate pain and stabilize the spine.

When CPT Code 22852 is Used?

This procedure is indicated in various clinical scenarios.

• Severe degenerative disc disease causing chronic back pain.
• Spondylolisthesis resulting in instability of the spine.
• Recurrent herniated discs that have not responded to conservative treatment.
• Spinal stenosis leading to significant neurological symptoms.

Symptoms Indicating This Procedure

Patients may report a variety of symptoms that suggest the need for this surgical intervention.

• Chronic lower back pain that limits daily activities.
• Radiating pain down the legs (sciatica).
• Numbness or tingling in the legs or feet.
• Muscle weakness in the lower extremities.

Causes and Risk Factors

Several factors can contribute to the conditions requiring this procedure.

• Age-related degeneration of spinal discs.
• Previous spinal injuries or trauma.
• Genetic predisposition to spinal disorders.
• Obesity increasing stress on the spine.

Diagnostic Tests Before Procedure

A variety of diagnostic tests are utilized to confirm the need for surgery.

• MRI scans to visualize soft tissue and nerve compression.
• CT scans 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 intervertebral disc.
• Prepare the vertebrae for fusion by cleaning the surfaces.
• Insert bone graft material between the vertebrae.
• Stabilize the spine using instrumentation such as screws and rods.
• 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 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 of 1-3 days for monitoring.
• Gradual return to normal activities over several weeks.
• Physical therapy to strengthen the back and improve mobility.
• 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 persistent pain or weakness.
• Non-union of the vertebrae requiring further surgery.
• Blood clots in the legs or lungs.

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Post-Procedure Follow-Up

Regular follow-up is essential to monitor recovery.

• Initial follow-up appointment within 2 weeks post-surgery.
• Subsequent visits at 6 weeks, 3 months, and 6 months.
• Imaging studies to assess fusion progress.

Alternative Treatments

There are non-surgical options available for managing symptoms.

• Physical therapy to strengthen back muscles.
• Chiropractic care for spinal alignment.
• Pain management techniques including injections.
• Medications such as NSAIDs for pain relief.

Home Care Tips

Patients can take steps at home to aid recovery.

• Follow prescribed physical therapy exercises.
• Use ice or heat packs to manage pain.
• Maintain a healthy diet to support healing.
• Avoid heavy lifting and strenuous activities.

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 low-impact exercise.
• Avoid smoking to promote better healing.

Billing and Coding Information

CPT Code: 22852

Category: Surgery

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

Related CPT Codes

• 22851 - Insertion of intervertebral biomechanical device
• 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