How To Use CPT Code 20664

CPT 20664 describes the application of a cranial halo, including removal, with the placement of six or more pins for thin skull osteology. 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 20664?

CPT 20664 is used to describe the application of a cranial halo, including removal, with the placement of six or more pins for thin skull osteology. This procedure is typically performed on patients with abnormal skull shapes, such as those with hydrocephalus or osteogenesis imperfecta, who require stabilization and correction of deformities or injuries to the cervical spine.

2. Official Description

The official description of CPT code 20664 is: ‘Application of halo, including removal, cranial, 6 or more pins placed, for thin skull osteology (eg, pediatric patients, hydrocephalus, osteogenesis imperfecta).’

3. Procedure

The procedure for CPT 20664 involves the application of a cranial halo to correct deformities or injuries to the cervical spine in patients with abnormal skull shapes. The provider places the halo ring around the upper frontal area of the skull bone and inserts six or more halo pins diagonally to each other. The pins are tightened with a torque screwdriver until they reach the desired depth in the skull bone. The provider then affixes the cranial halo device by tightening the remaining pairs of pins. Radiological imaging is used to confirm the alignment of the cervical spine. The patient also wears a vest that attaches to the halo for further stabilization. The service also includes the removal of the halo.

4. Qualifying circumstances

CPT 20664 is typically performed on pediatric patients with abnormal skull shapes, such as those with hydrocephalus or osteogenesis imperfecta. These conditions result in abnormal skull thickness and shape, requiring the application of a cranial halo for stabilization and correction of cervical spine deformities or injuries.

5. When to use CPT code 20664

CPT code 20664 should be used when a cranial halo is applied, including removal, with the placement of six or more pins for thin skull osteology. It is important to ensure that the procedure is performed on patients with qualifying circumstances, such as pediatric patients with abnormal skull shapes due to conditions like hydrocephalus or osteogenesis imperfecta.

6. Documentation requirements

To support a claim for CPT 20664, the provider must document the following information:

• Patient’s diagnosis and the need for cranial halo application
• Date of the procedure
• Details of the procedure, including the placement of six or more pins
• Confirmation of cervical spine alignment with radiological imaging
• Documentation of any additional procedures performed, such as halo removal
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 20664, ensure that the procedure includes the application of a cranial halo, including removal, with the placement of six or more pins for thin skull osteology. It is important to follow the specific documentation requirements and guidelines provided by the payer. Additionally, it is crucial to review any applicable modifiers or bundling rules to ensure accurate and appropriate billing.

8. Historical information

CPT 20664 was added to the Current Procedural Terminology system on January 1, 1998. There have been several historical changes to the code, including the addition and removal from the Inpatient Only (IPO) list for Medicare. It is important to stay updated with any changes or updates to ensure accurate coding and billing.

9. Similar codes to CPT 20664

There are no similar codes to CPT 20664 within the range of 20500-20705. This code specifically describes the application of a cranial halo, including removal, with the placement of six or more pins for thin skull osteology.

9. Examples

1. A pediatric patient with hydrocephalus requires the application of a cranial halo, including removal, with the placement of six pins to correct cervical spine deformities.
2. An individual with osteogenesis imperfecta undergoes the application of a cranial halo, including removal, with the placement of eight pins to stabilize and correct injuries to the cervical spine.
3. A patient with a thin skull osteology due to a bone formation disorder requires the application of a cranial halo, including removal, with the placement of six pins to address cervical spine deformities.
4. A pediatric patient with an abnormal skull shape resulting from hydrocephalus undergoes the application of a cranial halo, including removal, with the placement of seven pins to correct cervical spine injuries.
5. An individual with osteogenesis imperfecta requires the application of a cranial halo, including removal, with the placement of six pins to stabilize and correct deformities in the cervical spine.
6. A patient with a thin skull osteology due to a bone formation disorder undergoes the application of a cranial halo, including removal, with the placement of eight pins to address cervical spine injuries.
7. A pediatric patient with an abnormal skull shape resulting from hydrocephalus requires the application of a cranial halo, including removal, with the placement of six pins to correct cervical spine deformities.
8. An individual with osteogenesis imperfecta undergoes the application of a cranial halo, including removal, with the placement of seven pins to stabilize and correct injuries to the cervical spine.
9. A patient with a thin skull osteology due to a bone formation disorder requires the application of a cranial halo, including removal, with the placement of six pins to address cervical spine deformities.
10. A pediatric patient with an abnormal skull shape resulting from hydrocephalus undergoes the application of a cranial halo, including removal, with the placement of eight pins to correct cervical spine injuries.