Wiki External Fixator 20693 with 20694 Same Session

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GKS*dec21

GKS*dec21

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Provider makes adjustments to external fixator (under anesthesia) 20693, fixes a separate fracture and at the end of the service he removes the external fixator 20694. I have run NCCI edits and these codes do not bundle. Can't find a source that states these can't be billed together in the same session. These appear to me as a family of codes? Would appreciate some feedback and sources to give my provider.

Thanks :) ZDX0764
 
If the patient is multi-trauma, for example, and they have multiple fractures in different anatomic areas, it would be appropriate to report both if done at different anatomic locations during the same operative session.
Is that what you mean? e.g.; The patient had a LT, open tib/fib fracture too swollen for ORIF, it had an ex-fix placed prior, and the provider adjusts it but has to leave it on longer to wait for the swelling to go down before definitive fixation. At the same time, the patient also had a RT, open tibia fracture with an ex-fix placed earlier, and this one is ready for ORIF. He removes the ex-fix on the RT and performs ORIF at the same operative session.

I am not fully understanding your scenario. If you are talking about the same fracture and same ex-fix, it would not make sense to me to report both the adjustment and removal at the same operative session. If he had to adjust it while performing the case/in order to do the ORIF and then removes it, you would code the removal. Adjustment/revision implies they are leaving the ex-fix on for further healing. You might check CPT Assistant, if you have it, for guidance. Not sure if there are any articles on this topic specifically.

There could be other scenarios where you wouldn't report the removal. It depends on the documentation and the op note(s), global, fracture locations, etc.
 
amyjph said:
If the patient is multi-trauma, for example, and they have multiple fractures in different anatomic areas, it would be appropriate to report both if done at different anatomic locations during the same operative session.
Is that what you mean? e.g.; The patient had a LT, open tib/fib fracture too swollen for ORIF, it had an ex-fix placed prior, and the provider adjusts it but has to leave it on longer to wait for the swelling to go down before definitive fixation. At the same time, the patient also had a RT, open tibia fracture with an ex-fix placed earlier, and this one is ready for ORIF. He removes the ex-fix on the RT and performs ORIF at the same operative session.

I am not fully understanding your scenario. If you are talking about the same fracture and same ex-fix, it would not make sense to me to report both the adjustment and removal at the same operative session. If he had to adjust it while performing the case/in order to do the ORIF and then removes it, you would code the removal. Adjustment/revision implies they are leaving the ex-fix on for further healing. You might check CPT Assistant, if you have it, for guidance. Not sure if there are any articles on this topic specifically.

There could be other scenarios where you wouldn't report the removal. It depends on the documentation and the op note(s), global, fracture locations, etc.
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I appreciate your response and information you are offering, unfortunately my post was several years ago and I lost track of this, so I can't really speak on it now. :LOL:. Thanks again!
 
GKS*dec21 said:
I appreciate your response and information you are offering, unfortunately my post was several years ago and I lost track of this, so I can't really speak on it now. :LOL:. Thanks again!
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Oh, I just realized it was resurrected from the archives lol
 
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