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The CPT® Code 20697 refers to the application of a multiplane unilateral external fixation device, which is a specialized orthopedic procedure used to stabilize fractures or deformities of the bone. This procedure employs a stereotactic computer-assisted adjustment system, which enhances the precision of the fixation process. The term "multiplane" indicates that the external fixation device can be adjusted in multiple planes, allowing for comprehensive correction of complex intra-articular fractures or deformities. The use of imaging during the procedure aids in accurately positioning the external fixator components, which include struts, rings, bolts, cubes, and springs, collectively known as the spatial frame. The spatial frame is strategically placed around the affected bone and is secured using pins or wires that penetrate through the rings and/or struts into the bone itself. This external fixation method is particularly advantageous as it allows for dynamic stabilization, meaning that it can accommodate movement of the involved joint while still providing the necessary support for healing. The adjustments made to the spatial frame are facilitated by computer software, which enables the physician to make precise modifications to the alignment of the bone. This tailored approach ensures optimal correction of the deformity based on a patient-specific adjustment schedule. It is important to note that the exchange of a strut, which involves both the removal and replacement of the strut, is reported separately under this code for each strut that is exchanged, distinguishing it from the initial application and adjustments of the external fixation device.
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The procedure associated with CPT® Code 20697 is indicated for the treatment of specific conditions that require stabilization and correction of bone fractures or deformities. The following are the explicitly provided indications for this procedure:
The procedure for CPT® Code 20697 involves several critical steps to ensure the effective application of the multiplane unilateral external fixation device. Each step is essential for achieving the desired stabilization and correction of the fracture or deformity.
Following the application of the multiplane unilateral external fixation device, post-procedure care is essential for monitoring the patient's recovery and ensuring the effectiveness of the treatment. Patients are typically advised to follow a specific rehabilitation protocol, which may include physical therapy to maintain joint mobility and strength. Regular follow-up appointments are necessary to assess the alignment and stability of the fixation device, as well as to make any required adjustments based on the patient's healing progress. Additionally, any complications or signs of infection at the pin sites should be monitored closely, and appropriate interventions should be implemented as needed. The exchange of struts, if required, is performed under this code and includes both the removal and replacement of the strut, ensuring continued support and alignment throughout the recovery process.
| Short Descr | APP MLTPLN UNI XTRNL FIX XCH | Medium Descr | APP MLTPLN UNI XTRNL FIX STRTCTC ADJMT EXCHANGE | 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; exchange (ie, removal and replacement) of strut, each | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 3 - Technical Component Only Code | Multiple Procedures (51) | 0 - No 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 | Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 4 | CCS Clinical Classification | 161 - Other OR therapeutic procedures on bone |
| 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.) | 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.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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) |
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| 2024-01-01 | Changed | Short and Medium Descriptions changed. |
| 2010-01-01 | Changed | Code description changed. |
| 2009-01-01 | Added | - |
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