Overview of CPT Code 22858:Insertion of intervertebral biomechanical device

Overview of CPT Code 22858:Insertion of intervertebral biomechanical device

CPT Code 22858 refers to the surgical insertion of an intervertebral biomechanical device, which is used to stabilize the spine and alleviate pain caused by degenerative disc disease or spinal instability.

When CPT Code 22858 is Used?

This procedure is indicated in specific clinical scenarios.

• Severe degenerative disc disease causing significant pain and disability.
• Spinal instability due to trauma or degenerative conditions.
• Failed conservative treatments such as physical therapy and medication.
• Surgical intervention is necessary to restore spinal function.

Symptoms Indicating This Procedure

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

• Chronic back pain that does not improve with conservative treatment.
• Radiating pain into the legs or arms.
• Numbness or weakness in the extremities.
• Difficulty with mobility or performing daily activities.

Causes and Risk Factors

Several factors can contribute to the need for this procedure.

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

Diagnostic Tests Before Procedure

Several diagnostic tests may be performed to evaluate the condition of the spine.

• MRI to assess disc degeneration and spinal alignment.
• CT scans for detailed imaging of the spine.
• X-rays to evaluate spinal structure and alignment.
• Electromyography (EMG) to assess nerve function.

Procedure Description

The procedure involves several key steps.

• Patient is placed under general anesthesia.
• An incision is made in the back to access the spine.
• The damaged disc is removed, and the intervertebral biomechanical device is inserted.
• The device is positioned to stabilize the spine and promote healing.
• The incision is closed with sutures or staples.

Preparation for the Procedure

Patients should follow specific guidelines before the surgery.

• Avoid eating or drinking after midnight before the procedure.
• Discuss all medications with the healthcare provider.
• Arrange for transportation to and from the hospital.
• Follow any pre-operative instructions provided by the surgeon.

Recovery and Aftercare

Post-operative care is crucial for recovery.

• Expected recovery period is typically 6 to 12 weeks.
• Wound care instructions should be followed to prevent infection.
• Pain management may include prescribed medications.
• Physical therapy may be recommended to aid recovery.

Possible Complications

As with any surgical procedure, there are potential risks.

• Infection at the surgical site.
• Nerve damage leading to weakness or numbness.
• Device failure or displacement.
• Chronic pain or discomfort post-surgery.

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Post-Procedure Follow-Up

Regular follow-up is essential for monitoring recovery.

• Initial follow-up appointment within 1-2 weeks post-surgery.
• Subsequent visits every 4-6 weeks to monitor healing.
• Imaging studies may be repeated to assess device placement.

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 pain management regimen.
• Engage in light activities as tolerated.
• Avoid heavy lifting or strenuous activities.
• Maintain a healthy diet to support healing.

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 exercise to strengthen back muscles.
• Avoid smoking, which can impair healing.

Billing and Coding Information

CPT Code: 22858

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 $15,000 to $30,000.
• Insurance may cover a significant portion if deemed medically necessary.
• Pre-authorization may be required by insurance providers.

Related CPT Codes

• 22840 - Posterior spinal fusion, posterior approach, single level
• 22842 - Posterior spinal fusion, additional level
• 22851 - Insertion of intervertebral biomechanical device
• 22853 - Posterior lumbar interbody fusion
• 22859 - Posterior spinal fusion with instrumentation