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2025 CPT code 20660

Application and removal of cranial tongs, calipers, or stereotactic frame for cervical spine traction.

Follow all applicable CPT coding guidelines, especially those related to fracture and dislocation treatment and the use of modifiers for repeat procedures (Modifier 76) or when the initial treatment provider does not perform subsequent treatments (Modifier 54).

Modifiers 54 and 76 are applicable depending on whether the provider performing the initial traction also performs subsequent treatments and whether a repeat application is necessary.

Medical necessity for this procedure is established when a patient has a cervical spine fracture, dislocation, or spinal cord injury requiring traction to achieve or maintain proper alignment for healing or surgical intervention.The level of medical necessity is determined by the clinical picture, severity of injury, and response to treatment.

The physician or qualified healthcare professional is responsible for preparing the patient, inserting pins, applying traction, monitoring the patient's neurological status (with imaging and/or neurological exams), and removing the device once proper alignment is achieved.

In simple words: This code covers placing and removing a special device (cranial tongs, calipers, or a stereotactic frame) on the neck to pull on the spine.This is done to help heal broken bones or dislocations in the neck or treat spinal cord injuries.

This CPT code encompasses the application and removal of cranial tongs, calipers, or stereotactic frames used to apply traction to the cervical spine.This is performed for the treatment of cervical spine fractures, dislocations, or spinal cord injuries, and aids in maintaining spinal alignment during procedures like spinal surgery or MRI. The procedure includes the insertion of pins, application of traction force using weights, and subsequent removal of the device. Imaging guidance is reported separately.

Example 1: A patient presents with a cervical spine fracture after a motor vehicle accident.Cranial tongs are applied to provide traction, realign the vertebrae, and stabilize the fracture before surgical intervention., A patient with a cervical dislocation requires traction to facilitate reduction.Calipers are used to apply controlled traction to the cervical spine, maintaining alignment while imaging confirms successful reduction., A patient undergoes a cervical spinal fusion. A stereotactic frame is used to ensure precise positioning of the spinal instrumentation during the surgical procedure.

* Preoperative and postoperative neurological exams.* Radiographic images (X-rays, CT scans) before, during, and after traction application.* Detailed operative notes, including the type of traction device used, the amount of traction applied, and the duration of traction.* Any complications encountered during the procedure.

** Subsequent removal of the traction device is included in the basic procedure and should not be reported separately.Use of this code requires appropriate documentation to support medical necessity and justify the procedure.

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