How To Use CPT Code 20694

CPT 20694 describes the removal, under anesthesia, of an external fixation system. 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 20694?

CPT 20694 is used to describe the removal of an external fixation system while the patient is under anesthesia. An external fixation system is a device that is placed inside the bones to join two skeletal parts and maintain their alignment. The device remains outside of the body, allowing the provider to make adjustments externally without the need for invasive procedures. Once the defect has healed, the provider removes the external fixation system and any associated implants.

2. Official Description

The official description of CPT code 20694 is: ‘Removal, under anesthesia, of external fixation system.’

3. Procedure

During the procedure, the patient is appropriately prepped and anesthetized. The provider detaches the previously placed external multiplanar ring or uniplanar rod along with the pin. The deep inserter bone pins or screws are then removed. The provider unscrews the pins and slowly pulls them out using surgical forceps. They ensure the complete removal of any deep implant and then pack and suture the wound.

4. Qualifying circumstances

CPT 20694 is performed when there is a need to remove an external fixation system that was previously placed. This procedure is typically done when the defect has healed, and the patient no longer requires the external fixation system. The patient must be under anesthesia during the removal process.

5. When to use CPT code 20694

CPT code 20694 should be used when the provider is performing the removal of an external fixation system while the patient is under anesthesia. It is important to ensure that the patient meets the qualifying circumstances for this procedure and that the removal is necessary.

6. Documentation requirements

To support a claim for CPT 20694, the provider must document the following information:

• Reason for the removal of the external fixation system
• Date and time of the procedure
• Details of the external fixation system being removed
• Confirmation of complete removal of any deep implants
• Wound closure method

7. Billing guidelines

When billing for CPT 20694, ensure that the procedure meets the requirements for this code. It is important to report this code accurately and not to report it with other codes that may overlap or duplicate the services provided. Follow the specific guidelines provided by the payer to ensure proper reimbursement.

8. Historical information

CPT 20694 was added to the Current Procedural Terminology system on January 1, 1991. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 20694

There are no similar codes to CPT 20694 within the range of 20500-20705.

9. Examples

1. A patient had an external fixation system placed to stabilize a fracture. Once the fracture has healed, the provider performs the removal of the external fixation system under anesthesia using CPT code 20694.
2. Following a successful bone fusion procedure, the provider removes the external fixation system that was used during the healing process. CPT code 20694 is used to report the removal.
3. A patient with a severe bone infection required the placement of an external fixation system. After the infection has been treated and the bone has healed, the provider performs the removal of the external fixation system using CPT code 20694.
4. During a revision surgery, the provider decides to remove the external fixation system that was previously placed. CPT code 20694 is used to report the removal.
5. Following a successful limb lengthening procedure, the provider removes the external fixation system that was used during the lengthening process. CPT code 20694 is used to report the removal.
6. A patient with a complex fracture required the placement of an external fixation system. Once the fracture has healed, the provider performs the removal of the external fixation system under anesthesia using CPT code 20694.
7. After a bone graft procedure, the provider removes the external fixation system that was used to stabilize the graft. CPT code 20694 is used to report the removal.
8. A patient with a nonunion fracture underwent the placement of an external fixation system. Once the fracture has healed, the provider performs the removal of the external fixation system using CPT code 20694.
9. Following a successful joint fusion procedure, the provider removes the external fixation system that was used during the fusion process. CPT code 20694 is used to report the removal.
10. A patient with a severe bone deformity required the placement of an external fixation system. After the deformity has been corrected, the provider performs the removal of the external fixation system using CPT code 20694.