Overview of CPT Code 22867: Percutaneous vertebroplasty
Percutaneous vertebroplasty is a minimally invasive procedure used to treat vertebral compression fractures, typically caused by osteoporosis or trauma. The procedure involves the injection of a special cement into the fractured vertebra to stabilize it and alleviate pain.
When CPT Code 22867 is Used?
This procedure is indicated in specific clinical scenarios.
- Patients with painful vertebral compression fractures due to osteoporosis.
- Fractures resulting from trauma or malignancy.
- Patients who have not responded to conservative treatments such as pain medication or physical therapy.
Symptoms Indicating This Procedure
Patients typically report various symptoms that may lead to the consideration of this procedure.
- Severe back pain localized to the fracture site.
- Pain that worsens with movement or standing.
- Limited mobility or difficulty performing daily activities.
- Numbness or weakness in the legs if the fracture affects spinal nerves.
Causes and Risk Factors
Understanding the causes and risk factors can help in prevention and management.
- Osteoporosis, leading to weakened bones.
- Age-related bone density loss.
- Previous history of fractures.
- Certain cancers that metastasize to the spine.
- Long-term use of corticosteroids.
Diagnostic Tests Before Procedure
Several diagnostic tests are performed to confirm the need for vertebroplasty.
- X-rays to visualize the fracture.
- MRI to assess the extent of the fracture and any associated soft tissue damage.
- CT scans for detailed imaging of the vertebrae.
Procedure Description
The procedure is performed under local anesthesia and sedation.
- The patient is positioned comfortably, usually lying on their stomach.
- A small incision is made in the skin over the affected vertebra.
- A needle is inserted through the incision and guided into the fractured vertebra using imaging guidance.
- Bone cement is mixed and injected into the vertebra to stabilize it.
- The needle is removed, and the incision is closed with a bandage.
Preparation for the Procedure
Proper preparation is essential for a successful procedure.
- Patients should inform their doctor about all medications and supplements they are taking.
- Fasting for several hours before the procedure may be required.
- Arranging for transportation home after the procedure due to sedation.
Recovery and Aftercare
Recovery typically involves monitoring and care at home.
- Patients can usually go home the same day after a short observation period.
- Pain relief medications may be prescribed.
- Avoiding heavy lifting and strenuous activities for a few weeks.
- Follow-up appointments to monitor healing and pain relief.
Possible Complications
While generally safe, there are potential risks associated with the procedure.
- Infection at the injection site.
- Bleeding or hematoma formation.
- Allergic reaction to the cement material.
- Nerve damage or spinal cord injury in rare cases.
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Post-Procedure Follow-Up
Follow-up care is crucial for assessing recovery.
- Initial follow-up within one to two weeks post-procedure.
- Additional visits may be scheduled to monitor pain levels and mobility.
- Long-term follow-up to assess the stability of the vertebra and overall spine health.
Alternative Treatments
There are several non-surgical options available.
- Physical therapy to strengthen back muscles.
- Pain management with medications.
- Bracing to support the spine.
- Injections of corticosteroids or other medications to reduce inflammation.
Home Care Tips
Patients can take steps to aid their recovery at home.
- Rest and avoid activities that may strain the back.
- Use ice packs to reduce swelling and pain.
- Follow the prescribed medication regimen.
- Engage in gentle stretching and strengthening exercises as advised.
Patient Education & Prevention
Education is key to preventing future fractures.
- Maintain a healthy diet rich in calcium and vitamin D.
- Engage in weight-bearing exercises to strengthen bones.
- Avoid smoking and limit alcohol consumption.
- Regular bone density screenings for at-risk individuals.
Billing and Coding Information
CPT Code: 22867
Category: Surgical Procedures
Common Modifiers:
- -50
- -LT
- -RT
Average Cost and Insurance Coverage
Costs can vary based on location and insurance.
- Average cost ranges from $5,000 to $15,000.
- Most insurance plans cover the procedure if medically necessary.
- Patients should verify coverage with their insurance provider.
Related CPT Codes
Frequently Asked Questions (FAQs)
What is percutaneous vertebroplasty?
It is a minimally invasive procedure to stabilize fractured vertebrae and relieve pain.
How long does the procedure take?
The procedure typically takes about 1 to 2 hours.
What is the recovery time?
Most patients can return to normal activities within a few days.
Are there any risks involved?
As with any procedure, there are risks such as infection or bleeding.
Will my insurance cover this procedure?
Most insurance plans cover vertebroplasty if deemed medically necessary.
