How To Use CPT Code 20704

CPT code 20704 describes the manual preparation and insertion of drug-delivery devices into a joint as part of a separately reported primary 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 20704?

CPT 20704 can be used to describe the manual preparation and insertion of drug-delivery devices into a joint as part of a separately reported primary procedure. This code is used when a provider manually prepares a drug delivery device and inserts it into a joint to provide stable, sustained, localized delivery of a drug(s) for the treatment of conditions such as osteoarthritis or rheumatoid arthritis flare-ups, synovitis, and joint pain.

2. Official Description

The official description of CPT code 20704 is: ‘Manual preparation and insertion of drug-delivery device(s), intra-articular (List separately in addition to code for primary procedure).’ This code should be used in conjunction with the code for the primary procedure.

3. Procedure

Prior to the procedure, the provider manually prepares the drug delivery device. With the patient appropriately prepped and under anesthesia for a primary procedure, the provider inserts a biocompatible and biodegradable drug delivery system into the joint. This drug delivery system may include microspheres, nanoparticles, or liposomes that encapsulate drugs such as corticosteroids, DMARDs, or other anti-inflammatory drugs. The purpose of the drug delivery system is to provide stable, sustained, localized delivery of the drug(s) to the affected joint.

4. Qualifying circumstances

Patients eligible to receive CPT 20704 services are those who require the manual preparation and insertion of drug-delivery devices into a joint as part of a separately reported primary procedure. This may include patients with conditions such as osteoarthritis or rheumatoid arthritis flare-ups, synovitis, or joint pain. The drug delivery devices used must be biocompatible and biodegradable, and the drugs encapsulated within them should be anti-inflammatory or disease-modifying agents.

5. When to use CPT code 20704

CPT code 20704 should be used when a provider performs the manual preparation and insertion of drug-delivery devices into a joint as part of a separately reported primary procedure. This code should be used in addition to the code for the primary procedure.

6. Documentation requirements

To support a claim for CPT 20704, the provider must document the following information:

• Specific details of the drug delivery device(s) used
• Date and time of the procedure
• Indication for the procedure
• Details of the primary procedure
• Any complications or adverse events
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 20704, ensure that the procedure is performed as part of a separately reported primary procedure. Use the appropriate primary procedure code in addition to CPT code 20704. It is important to note that CPT code 20704 should not be reported in conjunction with certain other codes, such as 11981 and 27091. Additionally, for the removal of an intra-articular drug delivery device, report CPT code 20705 in addition to the primary procedure code.

8. Historical information

CPT code 20704 was added to the Current Procedural Terminology system on January 1, 2020. There have been no updates to the code since its addition.

9. Similar codes to CPT 20704

Five similar codes to CPT 20704 include:

• CPT 22864: Insertion of drug delivery device(s) into the spine for sustained release of therapeutic agents
• CPT 23040: Insertion of drug delivery device(s) into the hip joint for sustained release of therapeutic agents
• CPT 23473: Insertion of drug delivery device(s) into the shoulder joint for sustained release of therapeutic agents
• CPT 24370: Insertion of drug delivery device(s) into the elbow joint for sustained release of therapeutic agents
• CPT 25449: Insertion of drug delivery device(s) into the knee joint for sustained release of therapeutic agents

9. Examples

1. A provider manually prepares and inserts a drug delivery device into a patient’s knee joint as part of a primary procedure to treat osteoarthritis.
2. A provider manually prepares and inserts a drug delivery device into a patient’s shoulder joint as part of a primary procedure to treat rheumatoid arthritis flare-ups.
3. A provider manually prepares and inserts a drug delivery device into a patient’s hip joint as part of a primary procedure to treat synovitis.
4. A provider manually prepares and inserts a drug delivery device into a patient’s elbow joint as part of a primary procedure to treat joint pain.
5. A provider manually prepares and inserts a drug delivery device into a patient’s spine as part of a primary procedure to provide sustained release of therapeutic agents.
6. A provider manually prepares and inserts a drug delivery device into a patient’s joint to deliver disease-modifying antirheumatic drugs (DMARDs) for the treatment of rheumatoid arthritis.
7. A provider manually prepares and inserts a drug delivery device into a patient’s joint to deliver corticosteroids for the treatment of osteoarthritis flare-ups.
8. A provider manually prepares and inserts a drug delivery device into a patient’s joint to deliver anti-inflammatory drugs for the treatment of synovitis.
9. A provider manually prepares and inserts a drug delivery device into a patient’s joint to provide localized delivery of therapeutic agents for the treatment of joint pain.
10. A provider manually prepares and inserts a drug delivery device into a patient’s joint to provide sustained release of therapeutic agents for the treatment of various joint conditions.