Wiki +20704 ABX Beads at same time as Spacer?

[TnRushFan]

Hello everyone,

I need a little help with new add on code +20704.

My provider performed removal of total knee arthroplasty and implanted an antibiotic spacer (27488)...he then also mixed, formed and implanted antibiotic beads (20704).
The includes / excludes for 20704 are contradictory...

Optum Encoder Pro Code Book
Coding Tips:
…Do report 20704 with 11981, 27091, or 27488...

Optum Encoder Pro (same book)
Excludes Removal of Knee Prosthesis 27488...

+20704 does not list 27488 as a 'parent code'...but does indicate to use it together...
I have researched and found several references...but none of them really clear if I can report both when both spacer AND beads done.

Thanks in advance....

 

[TnRushFan]

Okay folks...after much more research I found the answer to my own question LOL...it is an issue with the electronic coding book my organization has purchased. See below the parenthetic notes and CPT assistant guidance....just in case someone else has the same issue.


Parenthetical Notes

(Use 20704 in conjunction with 22864, 22865, 23040, 23044, 23334, 24000, 24160, 25040, 25250, 25251, 26070, 26075, 26080, 26990, 27030, 27090, 27301, 27310, 27603, 27610, 28020)
(Do not report 20704 in conjunction with 11981, 27091, 27488)


CPT ®Assistant, March, 2020, Volume 30, Issue 3, Page 14
Frequently Asked Questions
Surgery/Musculoskeletal System

Question: In surgeries involving hip implant removal and placement of a manually fashioned nonarticulating drug-delivery device, is it appropriate to report code 20704 in conjunction with code 27091?

Answer: No, code 20704, Manual preparation and insertion of drug-delivery device(s), intra-articular (List separately in addition to code for primary procedure), may not be reported in conjunction with code 27091, Removal of hip prosthesis; complicated, including total hip prosthesis, methylmethacrylate with or without insertion of spacer, or with code 27488, Removal of prosthesis, including total knee prosthesis, methylmethacrylate with or without insertion of spacer, knee, because a spacer is included in the value of these codes. Therefore, the work associated with code 20704 is inherent (included) in codes 27091 and 27488. The parenthetical note following code 20704 specifically states that code 20704 may not be reported in conjunction with codes 11981, 27091, and 27488. A separate instructional parenthetical indicates that 20704 may only be reported in conjunction with 22864, 22865, 23040, 23044, 23334, 24000, 24160, 25040, 25250, 25251, 26070, 26075, 26080, 26990, 27030, 27090, 27301, 27310, 27603, 27610, 28020.