© Copyright 2025 American Medical Association. All rights reserved.
The CPT® Code 20696 refers to the application of a multiplane unilateral external fixation device that utilizes stereotactic computer-assisted adjustment, which is a sophisticated method of aligning and stabilizing fractures or deformities. This procedure is particularly beneficial for complex intra-articular fractures or deformities, where traditional fixation methods may not provide adequate support or alignment. The term 'multiplane' indicates that the external fixation device can be adjusted in multiple planes, allowing for simultaneous correction of various axes of a fracture or deformity. This dynamic type of fixation not only stabilizes the affected area but also permits mobility of the involved joint, which is crucial for patient recovery and rehabilitation. During the procedure, a spatial frame, which consists of external fixator components such as struts, rings, bolts, cubes, and springs, is positioned around the bone that requires treatment. Pins or wires are then inserted through the rings and/or struts and into the bone to secure the spatial frame in place. The precise alignment of the bone is achieved through the use of computer software, which enables the physician to make accurate adjustments based on a patient-specific adjustment schedule. This level of customization is essential for achieving optimal correction of the deformity. The code 20696 encompasses not only the initial application of the external fixation device but also any subsequent alignments, assessments, and computations of the adjustment schedules necessary for effective treatment.
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The procedure associated with CPT® Code 20696 is indicated for the treatment of specific conditions that require stabilization and alignment of bone structures. The following are the explicitly provided indications for this procedure:
The procedure for applying a multiplane unilateral external fixation device with stereotactic computer-assisted adjustment involves several critical steps:
After the application of the multiplane unilateral external fixation device, the patient will require careful monitoring and follow-up care. This includes regular assessments to evaluate the alignment and stability of the fixation device, as well as adjustments to the spatial frame according to the established adjustment schedule. Patients may also need to engage in rehabilitation exercises to maintain joint mobility and function during the healing process. It is essential to provide education on care for the external fixation device, including how to keep the area clean and signs of potential complications, such as infection or misalignment, that should be reported to the healthcare provider.
| Short Descr | APP MLTPLN UNI XTRNL FIX 1ST | Medium Descr | APP MLTPLN UNI XTRNL FIX STRTCTC ADJMT 1ST&SUBSQ | Long Descr | Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; initial and subsequent alignment(s), assessment(s), and computation(s) of adjustment schedule(s) | 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) | 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 | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 2 | CCS Clinical Classification | 161 - Other OR therapeutic procedures on bone |
| 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. | RT | Right side (used to identify procedures performed on the right side of the body) | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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. | 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.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 81 | Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number. | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code 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 | LT | Left side (used to identify procedures performed on the left side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2024-01-01 | Changed | Short and Medium Descriptions changed. |
| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2010-01-01 | Changed | Code description changed. |
| 2009-01-01 | Added | - |
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