Overview of CPT Code 22853:posterior-lumbar-interbody-fusion

Overview of CPT Code 22853:posterior-lumbar-interbody-fusion

CPT Code 22853 refers to the surgical procedure known as posterior lumbar interbody fusion, which is performed to stabilize the lumbar spine by fusing two or more vertebrae together using bone grafts and instrumentation.

When CPT Code 22853 is Used?

This procedure is indicated in various clinical scenarios.

• Severe degenerative disc disease causing significant pain and disability.
• Spondylolisthesis resulting in spinal instability.
• Recurrent herniated discs that have not responded to conservative treatment.
• Spinal stenosis leading to nerve compression and pain.
• Fractures or tumors affecting the stability of the lumbar spine.

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.
• Difficulty walking or standing for prolonged periods.

Causes and Risk Factors

Several factors can contribute to the conditions requiring this procedure.

• Age-related degeneration of spinal discs.
• Genetic predisposition to spinal disorders.
• Previous spinal injuries or trauma.
• Obesity increasing stress on the spine.
• Occupational hazards involving heavy lifting or repetitive motion.

Diagnostic Tests Before Procedure

Several diagnostic tests are utilized to evaluate the need for this procedure.

• Magnetic Resonance Imaging (MRI) to assess soft tissue and nerve involvement.
• Computed Tomography (CT) scans for detailed bone structure evaluation.
• X-rays to visualize spinal alignment and degeneration.
• Electromyography (EMG) to assess nerve function.
• Discography to evaluate disc pain.

Procedure Description

The procedure involves several key steps to ensure successful fusion.

• Patient is placed under general anesthesia.
• An incision is made in the lower back to access the spine.
• The affected disc is removed to relieve pressure on nerves.
• Bone graft material is placed in the disc space to promote fusion.
• Instrumentation such as rods and screws may be used for stabilization.
• The incision is closed with sutures or staples.

Preparation for the Procedure

Proper preparation is essential for a successful surgery.

• Complete pre-operative assessments and lab tests as directed.
• Avoid eating or drinking after midnight before the surgery.
• Discuss current medications with the surgeon, especially blood thinners.
• Arrange for post-operative transportation and assistance at home.
• Follow any specific instructions provided by the healthcare team.

Recovery and Aftercare

Recovery can vary, but certain guidelines are generally followed.

• Hospital stay may last 1-3 days post-surgery.
• Gradual return to normal activities over several weeks.
• Physical therapy may be recommended to aid recovery.
• Pain management with prescribed medications.
• Wound care instructions to prevent infection.

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 bone graft.
• Blood clots in the legs or lungs.
• Adverse reactions to anesthesia.

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Post-Procedure Follow-Up

Follow-up care is crucial for monitoring recovery.

• Initial follow-up appointment within 1-2 weeks post-surgery.
• Regular check-ups every few months for the first year.
• Imaging studies to assess fusion progress.
• Ongoing evaluation of pain and functional improvement.

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.
• 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.
• Engage in light activities as tolerated, avoiding heavy lifting.
• Use ice or heat packs to manage discomfort.
• Maintain a healthy diet to support healing.
• Keep follow-up appointments and communicate any concerns.

Patient Education & Prevention

Education is key to preventing future issues.

• Understand the importance of maintaining a healthy weight.
• Engage in regular exercise to strengthen back muscles.
• Practice good posture to reduce spinal strain.
• Avoid activities that put excessive stress on the back.
• Stay informed about spinal health and seek early treatment for symptoms.

Billing and Coding Information

CPT Code: 22853

Category: Surgical Procedures

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 the procedure if 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
• 22851 - Insertion of intervertebral biomechanical device
• 22612 - Spinal Fusion, Posterior or Lateral Approach, Single Level