How To Use CPT Code 20697

CPT code 20697 describes the application of multiplane (pins or wires in more than one plane), unilateral, external fixation with stereotactic computer-assisted adjustment, including imaging exchange of strut. 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 20697?

CPT code 20697 is used to describe the application of multiplane (pins or wires in more than one plane), unilateral, external fixation with stereotactic computer-assisted adjustment, including imaging exchange of strut. This code is used when a provider uses a computer-assisted stereotactic guidance system to precisely locate and plan the external fixation approach. The procedure involves the application of pins, wires, or rods to join two skeletal parts and maintain their alignment while promoting faster healing.

2. Official Description

The official description of CPT code 20697 is: ‘Application of multiplane (pins or wires in more than one plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging exchange (ie, removal and replacement) of strut, each.’

3. Procedure

The procedure for CPT code 20697 involves several steps:

1. The patient is appropriately prepped and anesthetized.
2. The provider determines which strut needs to be exchanged based on the computer schedule for correction.
3. The patient is positioned, and a temporary strut is placed on the stereotactic frame to maintain stability.
4. The provider removes the appropriate strut, replaces it with a new strut, and secures it.
5. The temporary strut is then removed.
6. The provider may confirm the satisfactory alignment of the fixation device or strut with an X-ray.

4. Qualifying circumstances

CPT code 20697 is used for patients who require the application of multiplane external fixation with stereotactic computer-assisted adjustment. This procedure is typically performed for skeletal deformities or injuries that require the use of skeletal fixation devices. The patient must meet the criteria for the specific procedure, and the provider must use a stereotactic computer-assisted guidance system to ensure precise placement and adjustment of the fixation device.

5. When to use CPT code 20697

CPT code 20697 should be used when a provider performs the application of multiplane external fixation with stereotactic computer-assisted adjustment, including imaging exchange of strut. This code should not be reported in conjunction with CPT codes 20692 or 20696. It is important to accurately document the procedure performed to support the use of CPT code 20697.

6. Documentation requirements

To support a claim for CPT code 20697, the provider must document the following information:

• Patient’s diagnosis and the need for multiplane external fixation with stereotactic computer-assisted adjustment
• Specific details of the procedure performed, including the exchange of strut
• Date and time of the procedure
• Confirmation of satisfactory alignment with an X-ray, if applicable
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 20697, ensure that the procedure meets the criteria for multiplane external fixation with stereotactic computer-assisted adjustment. Do not report CPT code 20697 in conjunction with CPT codes 20692 or 20696. It is important to accurately document the procedure performed to support the use of CPT code 20697. Follow any additional billing guidelines provided by the payer or coding guidelines.

8. Historical information

CPT code 20697 was added to the Current Procedural Terminology system on January 1, 2009. There have been no updates to the code since its addition. Prior to the addition of CPT code 20697, there were no specific codes available to describe this procedure.

9. Similar codes to CPT 20697

There are no similar codes to CPT code 20697 within the range of 20500-20705. This code is unique in describing the application of multiplane external fixation with stereotactic computer-assisted adjustment, including imaging exchange of strut.

9. Examples

1. A patient with a complex skeletal deformity undergoes the application of multiplane external fixation with stereotactic computer-assisted adjustment, including imaging exchange of strut.
2. A patient with a severe fracture requires the application of multiplane external fixation with stereotactic computer-assisted adjustment, including imaging exchange of strut.
3. A patient with a nonunion fracture undergoes the application of multiplane external fixation with stereotactic computer-assisted adjustment, including imaging exchange of strut.
4. A patient with a limb length discrepancy requires the application of multiplane external fixation with stereotactic computer-assisted adjustment, including imaging exchange of strut.
5. A patient with a complex skeletal infection undergoes the application of multiplane external fixation with stereotactic computer-assisted adjustment, including imaging exchange of strut.
6. A patient with a severe bone deformity undergoes the application of multiplane external fixation with stereotactic computer-assisted adjustment, including imaging exchange of strut.
7. A patient with a complex fracture requires the application of multiplane external fixation with stereotactic computer-assisted adjustment, including imaging exchange of strut.
8. A patient with a nonhealing bone defect undergoes the application of multiplane external fixation with stereotactic computer-assisted adjustment, including imaging exchange of strut.
9. A patient with a severe joint dislocation requires the application of multiplane external fixation with stereotactic computer-assisted adjustment, including imaging exchange of strut.
10. A patient with a complex bone tumor undergoes the application of multiplane external fixation with stereotactic computer-assisted adjustment, including imaging exchange of strut.