2025 CPT code 20690
(Active) Effective Date: N/A Surgery - General Introduction or Removal Procedures on the Musculoskeletal System Surgery/Musculoskeletal System Feed
Application of a uniplane (pins or wires in 1 plane), unilateral, external fixation system.
Modifiers can be applied to indicate specific circumstances, such as increased procedural services (modifier 22), reduced services (modifier 52), or multiple procedures (modifier 51).Modifiers 54, 55, and 56 may be used in shared surgical care scenarios.Laterality modifiers (LT, RT) can be applied to specify which side the procedure is performed.
Medical necessity is established by the presence of a fracture or deformity requiring surgical stabilization.Documentation must support the need for the chosen fixation method.
The physician is responsible for prepping and anesthetizing the patient, planning the fixation site, making the incisions, inserting the pins or wires, aligning and securing the external fixation device, and confirming proper placement with imaging studies (e.g., x-ray).
In simple words: This procedure involves placing pins or wires through the skin and into the bone on one side of your body to hold broken bone fragments in place while they heal. The pins/wires are attached to a frame outside the body.The “uniplane” means the pins are all positioned on the same plane or level.
This code describes the application of a uniplane external fixation system to one side of the body (unilateral).The system uses pins or wires inserted in a single plane.This type of fixation is commonly used for stabilizing fractures, particularly in the tibia (shinbone).
Example 1: A patient sustains a midshaft tibia fracture. Closed reduction is performed, followed by the application of a uniplane external fixator to stabilize the fracture., An open tibial plateau fracture is treated with debridement, irrigation, and application of a uniplane external fixator.Additional codes for debridement (e.g., 11010-11012) and fracture treatment (e.g., 27752) are reported., A patient with a distal tibia fracture undergoes percutaneous fixation using Kirschner wires, which are then attached to a uniplane external frame.
Documentation should include details of the fracture, type of fixation device used, number and placement of pins/wires, intraoperative details, and confirmation of placement.If debridement is performed, the extent of devitalized tissue removed should be documented.
** It's essential to distinguish between uniplane and multiplane fixation. Uniplane uses thicker pins/wires in a single plane, while multiplane (code 20692) involves thinner wires under tension in multiple planes (like the Ilizarov or Monticelli methods).Always ensure accurate documentation to support the specific code chosen.
- Revenue Code: P6B (MINOR PROCEDURES - MUSCULOSKELETAL)
- Payment Status: Active
- Specialties:Orthopedic Surgery, Trauma Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center