How To Use CPT Code 20520

CPT code 20520 describes the removal of a foreign body in the muscle or tendon sheath through a surgical incision at the site. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 20520?

CPT 20520 is used to describe the removal of a foreign body, such as a thorn, wood particle, bullet, or gravel, that is lodged in the muscle or tendon sheath. The procedure involves making a surgical incision at the site to relieve swelling, pain, and difficulty in movement of the affected body part.

2. Official Description

The official description of CPT code 20520 is: ‘Removal of foreign body in muscle or tendon sheath simple.’

3. Procedure

1. The patient is appropriately prepped and the area is anesthetized.
2. The provider makes a surgical incision over the targeted area and separates the tissues.
3. Once the muscle or tendon sheath is reached, the provider inspects the area and removes the foreign body.
4. The surgical opening is closed with sutures after thoroughly cleaning the site.
5. X-ray images may be used prior to the procedure to locate the foreign body in the soft tissue, and a post-procedure image may be taken to ensure complete removal.

4. Qualifying circumstances

CPT 20520 is used when there is a foreign body lodged in the muscle or tendon sheath that is causing symptoms such as swelling, pain, and difficulty in movement. The procedure is performed to relieve these symptoms and improve the patient’s condition. The foreign body can be an object originating from outside the body or displaced from another location within the body, such as shards of metal or a bone fragment.

5. When to use CPT code 20520

CPT code 20520 should be used when a foreign body is present in the muscle or tendon sheath and requires surgical removal. It is important to note that this code is specifically for simple removal procedures. If the removal is deeper or more complex, CPT code 20525 should be used instead. Additionally, if there are specific codes available for foreign body removal in other body areas, such as the head, neck, flank, spine, abdomen, wrist, forearm, and fingers, those codes should be used instead of CPT 20520.

6. Documentation requirements

To support a claim for CPT 20520, the following documentation is required:

• Patient’s diagnosis and symptoms related to the presence of the foreign body
• Description of the foreign body and its location
• Date of the procedure
• Details of the surgical incision and removal of the foreign body
• Any additional procedures performed, such as suturing and cleaning of the site
• Use of pre- and post-procedure imaging, if applicable

7. Billing guidelines

When billing for CPT 20520, ensure that the procedure involves the removal of a foreign body in the muscle or tendon sheath through a surgical incision. It is important to report radiologic imaging separately if used for locating or confirming the presence of the foreign body. If a deeper or more complex removal is performed, CPT code 20525 should be used instead. Avoid using CPT 20520 if there are specific codes available for foreign body removal in other body areas.

8. Historical information

CPT 20520 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A patient presents with a wood particle lodged in their muscle sheath, causing pain and limited movement. The provider performs a surgical incision and removes the foreign body, relieving the symptoms.
2. A patient comes in with a bullet lodged in their tendon sheath, resulting in swelling and difficulty in movement. The provider surgically removes the foreign body, improving the patient’s condition.
3. A patient has a thorn embedded in their muscle, causing persistent pain and swelling. The provider performs a surgical procedure to remove the foreign body, alleviating the symptoms.
4. A patient presents with gravel lodged in their tendon sheath, leading to discomfort and limited mobility. The provider surgically removes the foreign body, resulting in symptom relief.
5. A patient has a metal shard embedded in their muscle, causing inflammation and pain. The provider performs a surgical procedure to remove the foreign body, improving the patient’s condition.
6. A patient comes in with a bone fragment lodged in their tendon sheath, resulting in swelling and difficulty in movement. The provider surgically removes the foreign body, relieving the symptoms.
7. A patient presents with a wood particle embedded in their muscle, causing persistent pain and limited mobility. The provider performs a surgical procedure to remove the foreign body, resulting in symptom relief.
8. A patient has a bullet lodged in their tendon sheath, leading to discomfort and restricted movement. The provider surgically removes the foreign body, improving the patient’s condition.
9. A patient comes in with gravel embedded in their muscle, causing inflammation and pain. The provider performs a surgical procedure to remove the foreign body, relieving the symptoms.
10. A patient has a metal shard lodged in their tendon sheath, resulting in swelling and limited mobility. The provider surgically removes the foreign body, improving the patient’s condition.