CPT code 20705 is for the removal of an implantable intra-articular drug delivery device.
CPT code 20705 is for the removal of an implantable intra-articular drug delivery device. This code is used when a healthcare provider removes a device that was previously implanted to deliver medication directly into a joint.
For CPT code 20705 (Rmvl i-artic rx delivery dev), the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services
- Use this modifier if the removal of the intra-articular drug delivery device required significantly more effort or time than usual.
2. Modifier 50 - Bilateral Procedure
- Apply this modifier if the procedure was performed on both sides of the body during the same session.
3. Modifier 51 - Multiple Procedures
- Use this modifier when multiple procedures are performed during the same surgical session.
4. Modifier 52 - Reduced Services
- Apply this modifier if the procedure was partially reduced or eliminated at the physician's discretion.
5. Modifier 59 - Distinct Procedural Service
- Use this modifier to indicate that the removal of the intra-articular drug delivery device was a distinct service from other procedures performed on the same day.
6. Modifier 76 - Repeat Procedure by Same Physician
- Apply this modifier if the same physician performed the procedure more than once on the same day.
7. Modifier 77 - Repeat Procedure by Another Physician
- Use this modifier if a different physician performed the procedure more than once on the same day.
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
- Apply this modifier if the patient had 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
- Use this modifier if the procedure was unrelated to the original surgery and was performed during the postoperative period.
10. Modifier 80 - Assistant Surgeon
- Apply this modifier if an assistant surgeon was required during the procedure.
11. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Use this modifier if an assistant surgeon was necessary due to the unavailability of a qualified resident surgeon.
12. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery
- Apply this modifier if a physician assistant, nurse practitioner, or clinical nurse specialist assisted in the surgery.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
When considering whether Medicare reimburses for CPT code 20705, which pertains to the removal of an intra-articular drug delivery device, it is essential to consult the Medicare Physician Fee Schedule (MPFS) and Local Coverage Determinations (LCDs) for the most accurate and up-to-date information.
As of the latest available data, CPT code 20705 is generally reimbursed by Medicare, provided that the procedure meets the medical necessity criteria outlined by Medicare guidelines. The reimbursement amount can vary based on geographic location, the setting in which the service is provided, and other factors such as the provider's participation status with Medicare.
For a precise reimbursement amount, healthcare providers should refer to the MPFS or use the Medicare Fee Schedule Lookup Tool available on the Centers for Medicare & Medicaid Services (CMS) website. Additionally, consulting with your Medicare Administrative Contractor (MAC) can provide specific details tailored to your region and practice.
In summary, CPT code 20705 is reimbursed by Medicare, but the exact reimbursement amount should be verified through official Medicare resources or your MAC.
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