© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 20661 involves the application of a cranial halo device, which is specifically designed to stabilize the cervical spine. This procedure is critical in cases where immobilization of the cervical region is necessary, often due to trauma or surgical interventions. The process begins with the preparation of the patient's scalp, where the four pin insertion sites are carefully shaved and cleansed using an anti-infective agent to minimize the risk of infection. Local anesthesia is then administered to ensure the patient's comfort during the procedure. The halo device is strategically positioned over the skull, with the anterior pins being inserted first. These pins are carefully placed through the skin and advanced until they engage the bone in a designated area known as the 'safe zone,' which is located just below the greatest circumference of the skull. This careful placement is crucial to avoid complications, such as damage to the orbit or surrounding nerves. Following the insertion of the anterior pins, the posterior pins are placed, and the diagonally opposed pins are tightened simultaneously to achieve the desired bone penetration. To ensure the stability and proper depth of the halo device, lock nuts are tightened. Finally, rods are attached to the halo, connecting it to a vest, cast, or traction setup, and it is important to note that the removal of the halo device is included in this procedure.
© Copyright 2025 Coding Ahead. All rights reserved.
The application of a cranial halo device, as described by CPT® Code 20661, is indicated for various clinical situations where stabilization of the cervical spine is required. The following conditions may warrant this procedure:
The procedure for applying a cranial halo device involves several critical steps to ensure proper stabilization of the cervical spine. The following procedural steps are outlined:
Post-procedure care following the application of a cranial halo device includes monitoring the patient for any signs of complications, such as infection or discomfort at the pin sites. Patients are typically advised on how to care for the halo and the surrounding skin to maintain hygiene and prevent irritation. Regular follow-up appointments are essential to assess the stability of the device and the healing process of the cervical spine. The removal of the halo device is included in the procedure, and it is performed once the physician determines that the cervical spine has stabilized adequately.
| Short Descr | APPLICATION HALO CRANIAL | Medium Descr | APPLICATION HALO CRANIAL INCLUDING REMOVAL | Long Descr | Application of halo, including removal; cranial | 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) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | 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 | 214 - Traction, splints, and other wound care |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2024-01-01 | Changed | Short Description changed. |
| Pre-1990 | Added | Code added. |
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