How To Use CPT Code 20660
CPT 20660 describes the application of cranial tongs, caliper, or stereotactic frame, including removal (separate procedure). 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 20660?
CPT 20660 is used to describe the application of cranial tongs, caliper, or stereotactic frame, including removal (separate procedure). This code is used when a healthcare professional applies traction force to the cervical spine using devices such as cranial tongs, calipers, or stereotactic frames. The procedure helps in the treatment of cervical spine fractures, dislocations, or spinal cord injuries, as well as in maintaining proper alignment of the spine during diagnostic or therapeutic procedures.
2. Official Description
The official description of CPT code 20660 is: ‘Application of cranial tongs, caliper, or stereotactic frame, including removal (separate procedure).’ This code includes the application of traction force to the cervical spine using devices such as cranial tongs, calipers, or stereotactic frames, as well as the removal of these devices as a separate procedure.
3. Procedure
The procedure for CPT code 20660 involves the application of traction force to the cervical spine using cranial tongs, calipers, or stereotactic frames. The healthcare professional begins by inserting threaded pins on both sides of the patient’s head simultaneously. These pins are tightened until the desired amount of compressive force is achieved. A spring-loaded mechanism in one of the pins indicates the exact level of compressive force. Once the device is in place, longitudinal traction is applied using weights attached to the tongs. The healthcare professional gradually increases the traction force by adding weights at regular intervals. Throughout the procedure, the healthcare professional performs neurological evaluations and obtains X-rays to monitor the progress and alignment of the dislocated or fractured bones. The procedure continues until the desired alignment is achieved.
4. Qualifying circumstances
CPT 20660 is performed in cases where patients have cervical spine fractures, dislocations, or spinal cord injuries that require the application of traction force for treatment or proper alignment. The procedure is typically performed by a healthcare professional who is trained and qualified to use cranial tongs, calipers, or stereotactic frames. It is important to note that CPT 20660 should not be reported separately for the use of tongs during a cervical laminectomy, as it is considered part of the related procedure.
5. When to use CPT code 20660
CPT code 20660 should be used when a healthcare professional applies cranial tongs, calipers, or stereotactic frames to provide traction force to the cervical spine for the treatment of fractures, dislocations, or spinal cord injuries. It is important to note that this code should not be reported separately for the use of tongs during a cervical laminectomy.
6. Documentation requirements
To support a claim for CPT 20660, the healthcare professional must document the following information:
- Patient’s diagnosis requiring the application of traction force
- Specific devices used, such as cranial tongs, calipers, or stereotactic frames
- Date of the procedure
- Details of the procedure, including the application of traction force and any adjustments made
- Neurological evaluations performed during the procedure
- X-ray results and documentation of bone alignment
- Signature of the healthcare professional performing the procedure
7. Billing guidelines
When billing for CPT 20660, ensure that the procedure involves the application of cranial tongs, calipers, or stereotactic frames, including their removal as a separate procedure. It is important to note that CPT 20660 should not be reported separately for the use of tongs during a cervical laminectomy. Additionally, imaging guidance for the procedure should be reported separately.
8. Historical information
CPT 20660 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.
9. Similar codes to CPT 20660
Five similar codes to CPT 20660 include:
- CPT 20661: Application of cranial tongs, caliper, or stereotactic frame, including removal (separate procedure), each additional day
- CPT 20662: Application of halo, caliper, or vest device (including removal), cranial, cervical, or cervicothoracic; cranial
- CPT 20663: Application of halo, caliper, or vest device (including removal), cranial, cervical, or cervicothoracic; cervical or cervicothoracic
- CPT 20664: Application of halo, caliper, or vest device (including removal), cranial, cervical, or cervicothoracic; cranial and cervical or cervicothoracic
- CPT 20665: Application of halo, caliper, or vest device (including removal), cranial, cervical, or cervicothoracic; cranial, cervical, and cervicothoracic
9. Examples
- A patient with a cervical spine fracture undergoes the application of cranial tongs to provide traction force for proper alignment.
- A healthcare professional applies a stereotactic frame to a patient with a spinal cord injury to maintain proper alignment during a diagnostic procedure.
- Cranial tongs are used to provide traction force for a patient with a dislocated cervical spine.
- A caliper device is applied to a patient with a cervical spine fracture to assist in the treatment and alignment of the bones.
- A healthcare professional uses cranial tongs to apply traction force to a patient with a spinal cord injury during a therapeutic procedure.
- Stereotactic frames are utilized to maintain proper alignment of the cervical spine in a patient with a dislocated vertebra.
- A caliper device is applied to a patient with a spinal cord injury to provide traction force and assist in the alignment of the spine.
- Cranial tongs are used to apply traction force to a patient with a cervical spine fracture, aiding in the treatment and alignment of the bones.
