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The procedure described by CPT® Code 20805 refers to the surgical replantation of a forearm that has been completely amputated, specifically between the wrist and elbow. This complex surgical intervention is performed under general anesthesia to ensure the patient is fully unconscious and pain-free during the operation. The process begins with the careful removal of any damaged tissue surrounding the amputation site, which is crucial for promoting healing and reducing the risk of infection. Following this, the ends of the amputated bones, namely the radius and ulna, are meticulously trimmed to facilitate a proper alignment and connection. This preparation is essential as it aids in the subsequent steps of suturing the soft tissues, including arteries, veins, nerves, muscles, and tendons, which are all critical for restoring function and sensation to the limb. In cases where there is a lack of skin coverage, a graft is utilized to protect the underlying structures. Additionally, any exposed nerves, tendons, and joints may require coverage through a free-tissue transfer, which includes its own blood supply via associated arteries and veins. Finally, the surgical site is closed in layers to ensure optimal healing and support for the reattached structures.
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The procedure of replantation of the forearm, as described by CPT® Code 20805, is indicated for patients who have experienced a complete amputation of the forearm between the wrist and elbow. This may occur due to traumatic injuries such as accidents, severe lacerations, or other incidents that result in the loss of the forearm. The primary goal of this procedure is to restore the functionality and appearance of the limb, as well as to preserve the integrity of the surrounding tissues and structures.
The replantation procedure involves several critical steps to ensure the successful reconnection of the amputated forearm. Each step is designed to meticulously restore the anatomical and functional integrity of the limb.
After the replantation procedure, patients typically require close monitoring in a recovery setting to assess the viability of the reattached limb. Post-operative care may include pain management, wound care, and physical therapy to regain function. Patients are advised to follow specific instructions regarding activity restrictions and care of the surgical site to promote healing and prevent complications. Regular follow-up appointments are essential to monitor the recovery process and address any concerns that may arise during the healing period.
| Short Descr | REPLANT FOREARM COMPLETE | Medium Descr | REPLANTATION FOREARM COMPLETE AMPUTATION | Long Descr | Replantation, forearm (includes radius and ulna to radial carpal joint), complete amputation | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 164 - Other OR therapeutic procedures on musculoskeletal system |
This is a primary code that can be used with these additional add-on codes.
| 20702 | Add-on Code MPFS Status: Active Code APC N Manual preparation and insertion of drug-delivery device(s), intramedullary (List separately in addition to code for primary procedure) |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. |
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| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
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