Overview of CPT Code 22859:posterior-spinal-fusion-with-instrumentation

Overview of CPT Code 22859:posterior-spinal-fusion-with-instrumentation

CPT Code 22859 refers to a surgical procedure known as posterior spinal fusion with instrumentation, which is performed to stabilize the spine by fusing together vertebrae using metal rods and screws.

When CPT Code 22859 is Used?

This procedure is indicated in various clinical scenarios.

• Severe spinal instability due to trauma or degenerative disease.
• Scoliosis or other spinal deformities requiring correction.
• Failed conservative treatment for chronic back pain.
• Tumors affecting spinal stability.

Symptoms Indicating This Procedure

Patients may present with several symptoms that warrant this surgical intervention.

• Chronic back pain that does not improve with conservative treatment.
• Numbness or weakness in the legs.
• Difficulty walking or maintaining balance.
• Visible spinal deformity.

Causes and Risk Factors

Several factors can contribute to the need for this procedure.

• Degenerative disc disease.
• Spinal fractures from trauma.
• Congenital spinal deformities.
• Previous spinal surgeries leading to instability.

Diagnostic Tests Before Procedure

Several diagnostic tests are essential to evaluate the patient's condition.

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

Procedure Description

The surgical procedure involves several key steps.

• Administer anesthesia to the patient.
• Make an incision along the back to access the spine.
• Remove any damaged or diseased tissue.
• Align the vertebrae and place bone graft material.
• Insert metal rods and screws to stabilize the spine.
• Close the incision with sutures or staples.

Preparation for the Procedure

Patients should follow specific guidelines before surgery.

• Avoid eating or drinking after midnight before the surgery.
• 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 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.
• Blood clots in the legs.
• Hardware failure or misalignment.

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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.
• Regular imaging to assess spinal stability.

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 for inflammation.

Home Care Tips

Patients can take steps to aid their recovery at home.

• Keep the surgical site clean and dry.
• Avoid heavy lifting and strenuous activities.
• Use ice packs to reduce swelling.
• Follow the prescribed medication regimen.

Patient Education & Prevention

Educating patients can help prevent future issues.

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

Billing and Coding Information

CPT Code: 22859

Category: Surgery

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 $80,000.
• Insurance typically covers medically necessary procedures.
• Out-of-pocket costs depend on the insurance plan.

Related CPT Codes

• 22840 - Posterior spinal fusion, posterior approach, single level
• 22842 - Posterior spinal fusion, additional level
• 22851 - Insertion of intervertebral biomechanical device
• 22630 - Posterior Lumbar Interbody Fusion
• 22633 - Spinal Fusion, Posterior Interbody