CPT® Code 72292

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1. Indications

The procedure associated with CPT® Code 72292 is indicated for various conditions affecting the vertebral body, particularly when there is a need to stabilize a vertebra that has collapsed, compressed, or fractured. The following are specific indications for performing this procedure:

• Vertebral Compression Fractures - These fractures often occur due to osteoporosis or trauma, leading to pain and loss of height in the vertebra.
• Vertebral Body Collapse - This condition can result from various factors, including malignancy or degenerative diseases, necessitating intervention to restore structural integrity.
• Chronic Pain Relief - Patients experiencing persistent pain due to vertebral instability may benefit from this procedure to improve their quality of life.

2. Procedure

The procedure for CPT® Code 72292 involves several critical steps that ensure the effective stabilization of the vertebral body under CT guidance. The following outlines the procedural steps:

• Step 1: Patient Preparation - The patient is positioned appropriately to allow optimal access to the affected vertebra. The area is cleaned and sterilized to minimize the risk of infection.
• Step 2: Imaging Guidance Setup - Continuous CT imaging is initiated to provide real-time visualization of the vertebral anatomy and the defect that requires treatment.
• Step 3: Needle Insertion - A specialized needle is carefully guided into the vertebral body using the CT images for precise placement. The needle is advanced to the site of the defect, ensuring accurate targeting.
• Step 4: Cavity Creation (if necessary) - If the vertebra is significantly collapsed, inflatable instruments may be inserted to create a cavity. This step is crucial for restoring the normal height of the vertebral body before cement injection.
• Step 5: Cement Injection - Once the cavity is prepared, a mixture of bone cement and contrast medium is injected into the vertebral body. The injection is monitored via CT to ensure complete filling of the intertrabecular bone marrow space.
• Step 6: Needle Withdrawal - After confirming that the cement has adequately filled the defect, the needle is withdrawn. If required, the procedure may be repeated on the opposite side to achieve symmetry and stability.
• Step 7: Documentation - The physician completes a written report detailing the radiological supervision and interpretation of the procedure, including any observations made during the intervention.

3. Post-Procedure

After the completion of the procedure associated with CPT® Code 72292, patients are typically monitored for any immediate complications. Post-procedure care may include pain management strategies and instructions for activity restrictions to promote healing. Patients are often advised to avoid heavy lifting or strenuous activities for a specified period. Follow-up imaging may be scheduled to assess the effectiveness of the procedure and ensure that the bone cement has remained stable within the vertebral body. The physician will provide specific guidelines based on the individual patient's condition and response to the procedure.