CPT Code 20680
CPT code 20680 is for the removal of a support implant, typically used in surgical procedures to extract devices like screws or plates.
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What is CPT Code 20680
CPT code 20680 is used for the removal of a support implant, such as a rod, pin, or screw, that was previously placed in the body to aid in the healing of a bone or joint. This code is specifically for cases where the implant is deeply embedded and requires a more complex surgical procedure to remove.
Does CPT 20680 Need a Modifier?
For CPT code 20680, "Removal of support implant," the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 - Increased Procedural Services: Used when the work required to perform the procedure is substantially greater than typically required. This could be due to complications or additional time and effort needed.
2. Modifier 50 - Bilateral Procedure: Used if the procedure is performed on both sides of the body during the same operative session.
3. Modifier 51 - Multiple Procedures: Used when multiple procedures are performed during the same surgical session. This modifier indicates that the removal of the support implant is one of several procedures.
4. Modifier 58 - Staged or Related Procedure or Service by the Same Physician During the Postoperative Period: Used if the removal of the support implant is planned or staged as part of a series of procedures.
5. Modifier 59 - Distinct Procedural Service: Used to indicate that the removal of the support implant is a distinct procedure from other services performed on the same day.
6. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: Used if the same procedure is repeated by the same provider.
7. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: Used if the same procedure is repeated by a different provider.
8. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: Used if the patient needs to return to the operating room for a related procedure during the postoperative period.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used if the removal of the support implant is unrelated to the original procedure and occurs during the postoperative period of the initial surgery.
10. Modifier LT - Left Side: Used to specify that the procedure was performed on the left side of the body.
11. Modifier RT - Right Side: Used to specify that the procedure was performed on the right side of the body.
12. Modifier 99 - Multiple Modifiers: Used when more than four modifiers are necessary to describe the procedure accurately.
These modifiers help provide additional information about the circumstances of the procedure, ensuring accurate billing and reimbursement.
CPT Code 20680 Medicare Reimbursement
Medicare does reimburse for CPT code 20680, which pertains to the removal of a support implant. The reimbursement amount can vary based on several factors, including geographic location, the specific Medicare Administrative Contractor (MAC) overseeing the claim, and whether the procedure is performed in a facility or non-facility setting. As of the latest available data, the national average reimbursement for CPT code 20680 typically ranges from approximately $400 to $600. However, it is essential to verify the exact reimbursement rate with your local MAC and consider any updates to the Medicare Physician Fee Schedule (MPFS) for the most accurate and current information.
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