CPT code 20696 is for the application of a complex multiplane external fixation device used in orthopedic procedures.
CPT code 20696 is for the application of a multiplane external fixation system. This procedure involves placing a complex external device that stabilizes and aligns bones or bone fragments from multiple angles, often used in cases of severe fractures or bone deformities.
For CPT code 20696, which refers to "Comp multiplane ext fixation," the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services
- Use this modifier if the procedure required significantly greater effort than typically required. This could be due to factors such as increased complexity or time.
2. Modifier 51 - Multiple Procedures
- Apply this modifier when multiple procedures are performed during the same session. This helps indicate that the procedure was part of a series of multiple services.
3. Modifier 58 - Staged or Related Procedure or Service by the Same Physician During the Postoperative Period
- This modifier is used if the procedure was planned or anticipated (staged) or more extensive than the original procedure, or for therapy following a surgical procedure.
4. Modifier 59 - Distinct Procedural Service
- Use this modifier to indicate that the procedure was distinct or independent from other services performed on the same day. This is particularly relevant if the procedures are not typically reported together but are appropriate under the circumstances.
5. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional
- Apply this modifier if the same procedure is repeated by the same provider. This helps to clarify that the repeat procedure was necessary.
6. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional
- Use this modifier when the same procedure is repeated by a different provider. This indicates that the repeat procedure was necessary and performed by another professional.
7. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period
- This modifier is used if the patient needs to return to the operating room for a related procedure during the postoperative period of the initial surgery.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Apply this modifier when an unrelated procedure is performed by the same provider during the postoperative period of the initial surgery.
9. Modifier 80 - Assistant Surgeon
- Use this modifier if an assistant surgeon was necessary for the procedure. This indicates that another surgeon assisted in the operation.
10. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- This modifier is used when an assistant surgeon is required because a qualified resident surgeon was not available.
11. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery
- Apply this modifier when a physician assistant, nurse practitioner, or clinical nurse specialist assists in the surgery.
Each of these modifiers serves a specific purpose and helps to provide additional information about the circumstances under which CPT code 20696 was performed. Proper use of these modifiers ensures accurate billing and reimbursement.
Medicare does reimburse for CPT code 20696, which pertains to the application of a multiplane external fixation device. The reimbursement amount can vary based on several factors, including geographic location and specific Medicare Administrative Contractor (MAC) policies. As of the latest available data, the national average reimbursement for CPT code 20696 is approximately $1,200. However, it is essential to verify the exact reimbursement rate with your local MAC or through the Medicare Physician Fee Schedule (MPFS) for the most accurate and up-to-date information.
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