Coding Musculoskeletal Drug Delivery Devices

This edition of “Spotlight on CPT” will present information regarding the coding for drug delivery devices found in the Musculoskeletal System of CPT.  A drug delivery system is a method of supplying medication, particularly antibiotics but also other therapeutic substances, to a targeted area of the body.  Different methodologies include beads, nails, or spacers.  Treatment with drug delivery devices can focus on the specific site of osteomyelitis, or aid in the prevention of infection post-joint replacement surgery. 

Source: https://www.youtube.com/watch?v=Qxzh4RpPVuQ

 

With the 2020 CPT code updates, six new codes were added relative to these devices.  These new codes allow for capturing the work involved with the manual preparation/mixing and insertion of the medication or with their removal.  These six codes, 20700-20705, are all add-on codes that are to be assigned in addition to the code for the primary procedure.  Notice that the code pairs focus on an anatomic location, ie. subfascial, intramedullary, or intra-articular.

20700-manual preparation and insertion of drug-delivery device(s), deep (eg, subfascial)

20701-removal of drug-delivery device(s), deep (eg, subfascial) 

20702-manual preparation and insertion of drug-delivery device(s), intramedullary

20703-removal of drug-delivery device(s), intramedullary

20704-manual preparation and insertion of drug-delivery device(s), intra-articular

20705-removal of drug-delivery device(s), intra-articular

It are several important notes to be aware of regarding the use of these codes.  First, if prefabricated drug devices are utilized, these codes do not apply.  Second, these codes may only be reported once per anatomical site.  Finally, while the new removal codes are meant to be used as add-on codes, if the only procedure performed is the removal of the drug delivery system without a primary procedure, the appropriate removal code is 20680.  

Now, light has been shed on coding for drug delivery systems.

About the Author 

Dianna Foley, RHIA, CHPS, CCS  is OHIMA's Coding Education Coordinator. Dianna has been an HIM professional for 20 years. She progressed through the ranks of coder, department supervisor, and department director, to her current role as a coding consultant. 

She recently served as the program director for Medical Coding and HIT at Eastern Gateway Community College. Dianna earned her bachelor's degree from the University of Cincinnati subsequently achieving her RHIA, CHPS, and CCS certifications. She is an AHIMA Approved ICD-10-CM/PCS Trainer and a a presenter at regional HIM meetings and the OHIMA Annual Meeting.