Orthopedic Coding Alert

Reader Question:

Include Halo Adjustment in Global

Question: Is there a code for adjusting a cervical halo without using anesthesia, or would this simply be part of the office visit?

Chicago Subscriber

Answer: If the physician made the adjustment during the postoperative period, you shouldn't charge for it because periodic adjustments in the office are a component of halo care. Depending on how the surgeon accomplished the original procedure, you probably reported either 20661 (Application of halo, including removal; cranial) or 20664 (Application of halo, including removal, cranial, 6 or more pins placed, for thin skull osteology [e.g., pediatric patients, hydrocephalus, osteogenesis imperfecta], requiring general anesthesia). Each procedure carries a 90-day global period.
 
After the global period ends, you should factor halo adjustments into your E/M visits (99211-99215 for established outpatients).

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