Overview of CPT Code 22857: Posterior spinal fusion, interbody technique

Overview of CPT Code 22857: Posterior spinal fusion, interbody technique

CPT Code 22857 refers to a 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 22857 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.
• Failed conservative treatment for spinal conditions.

Symptoms Indicating This Procedure

Patients may report several 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.
• 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.
• Congenital spinal deformities.
• Previous spinal surgeries that have failed.

Diagnostic Tests Before Procedure

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

• MRI to visualize soft tissue and nerve involvement.
• CT scans for detailed bone structure assessment.
• X-rays to evaluate spinal alignment and stability.
• Electromyography (EMG) to assess nerve function.

Procedure Description

The procedure involves several key steps.

• 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) 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 before the 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.

• Stay in the hospital for 1-3 days for monitoring.
• Gradually increase activity 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 vertebrae (failure to fuse).
• 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 spinal issues.

• 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.

• Keep the surgical site clean and dry.
• Avoid heavy lifting and twisting movements.
• Use ice packs to reduce swelling.
• Follow a balanced diet to promote healing.

Patient Education & Prevention

Understanding the condition can help prevent recurrence.

• Maintain a healthy weight to reduce spinal stress.
• Engage in regular low-impact exercise.
• Practice good posture to support spinal health.
• Avoid smoking, which can impede healing.

Billing and Coding Information

CPT Code: 22857

Category: Surgical Procedures

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 deemed medically necessary.
• Out-of-pocket costs depend on the patient's 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