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The CPT® Code 20704 refers to the manual preparation and insertion of drug-delivery device(s) that are placed intra-articularly, meaning they are inserted directly into a joint space. This procedure is typically performed in conjunction with a primary surgical procedure aimed at addressing joint issues, such as resecting an infected joint. The process involves the creation of a hand-crafted drug delivery device, which is designed to release medication directly into the joint area to aid in treatment. The surgeon prepares the device by mixing surgical cement powder with antibiotic powder, followed by the addition of a liquid monomer, and this mixture is processed under a vacuum to ensure proper consistency and effectiveness. Once the cement mixture is ready, it is poured into a silicone mold to form the device. After the cement hardens, the mold is removed, and the surgeon checks the device to ensure it is appropriately sized and shaped for the specific joint space. The final step involves attaching the device to the end of the bone using another batch of cement before closing the surgical wound in layers. This procedure is critical for delivering localized treatment to the joint, particularly in cases of infection or other joint-related conditions.
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The procedure associated with CPT® Code 20704 is indicated for the treatment of conditions that necessitate the delivery of medication directly into a joint space. This includes, but is not limited to, the following:
The procedure for CPT® Code 20704 involves several critical steps to ensure the successful preparation and insertion of the drug-delivery device:
Post-procedure care following the insertion of the drug delivery device involves monitoring the surgical site for signs of infection or complications. The patient may require follow-up visits to assess the effectiveness of the drug delivery and to ensure that the device remains properly positioned within the joint. Additionally, the surgical wound should be kept clean and dry, and any prescribed medications should be taken as directed to support recovery and manage pain.
| Short Descr | MNL PREP&INSJ I-ARTIC RX DEV | Medium Descr | MANUAL PREP&INSJ I-ARTIC DRUG DELIVERY DEVICE | Long Descr | Manual preparation and insertion of drug-delivery device(s), intra-articular (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service 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) | 0 - 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 | Items and Services Packaged into APC Rates | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 22864 | MPFS Status: Active Code APC C Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical | 22865 | MPFS Status: Restricted APC C PUB 100 CPT Assistant Article Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar | 23040 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Arthrotomy, glenohumeral joint, including exploration, drainage, or removal of foreign body | 23044 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Arthrotomy, acromioclavicular, sternoclavicular joint, including exploration, drainage, or removal of foreign body | 23334 | MPFS Status: Active Code APC J1 ASC G2 Removal of prosthesis, includes debridement and synovectomy when performed; humeral or glenoid component | 23335 | MPFS Status: Active Code APC C Removal of prosthesis, includes debridement and synovectomy when performed; humeral and glenoid components (eg, total shoulder) | 23473 | MPFS Status: Active Code APC J1 Revision of total shoulder arthroplasty, including allograft when performed; humeral or glenoid component | 23474 | MPFS Status: Active Code APC C Revision of total shoulder arthroplasty, including allograft when performed; humeral and glenoid component | 24000 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Arthrotomy, elbow, including exploration, drainage, or removal of foreign body | 24160 | MPFS Status: Active Code APC Q2 ASC A2 Illustration for Code Removal of prosthesis, includes debridement and synovectomy when performed; humeral and ulnar components | 24370 | MPFS Status: Active Code APC J1 ASC J8 Revision of total elbow arthroplasty, including allograft when performed; humeral or ulnar component | 24371 | MPFS Status: Active Code APC J1 ASC J8 Revision of total elbow arthroplasty, including allograft when performed; humeral and ulnar component | 25040 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Arthrotomy, radiocarpal or midcarpal joint, with exploration, drainage, or removal of foreign body | 25250 | MPFS Status: Active Code APC Q2 ASC A2 Removal of wrist prosthesis; (separate procedure) | 25251 | MPFS Status: Active Code APC Q2 ASC A2 Removal of wrist prosthesis; complicated, including total wrist | 25449 | MPFS Status: Active Code APC J1 ASC A2 Revision of arthroplasty, including removal of implant, wrist joint | 26070 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Arthrotomy, with exploration, drainage, or removal of loose or foreign body; carpometacarpal joint | 26990 | MPFS Status: Active Code APC J1 ASC A2 Illustration for Code Incision and drainage, pelvis or hip joint area; deep abscess or hematoma | 27030 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Arthrotomy, hip, with drainage (eg, infection) | 27090 | MPFS Status: Active Code APC C Illustration for Code Removal of hip prosthesis; (separate procedure) | 27132 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft | 27134 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Revision of total hip arthroplasty; both components, with or without autograft or allograft | 27137 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft | 27138 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Revision of total hip arthroplasty; femoral component only, with or without allograft | 27301 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Incision and drainage, deep abscess, bursa, or hematoma, thigh or knee region | 27310 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Arthrotomy, knee, with exploration, drainage, or removal of foreign body (eg, infection) | 27487 | MPFS Status: Active Code APC C CPT Assistant Article Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component | 27603 | MPFS Status: Active Code APC J1 ASC A2 Illustration for Code Incision and drainage, leg or ankle; deep abscess or hematoma | 27610 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Arthrotomy, ankle, including exploration, drainage, or removal of foreign body | 27703 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Arthroplasty, ankle; revision, total ankle | 28020 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Arthrotomy, including exploration, drainage, or removal of loose or foreign body; intertarsal or tarsometatarsal joint |
| 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. | 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) | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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 | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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). | 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). | F1 | Left hand, second digit | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | 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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| 2020-01-01 | Added | Code added. |
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