2025 CPT code 20664
(Active) Effective Date: N/A Surgery - Musculoskeletal System Feed
Application of a cranial halo, including removal, for patients with thin skull osteology (e.g., pediatric patients with hydrocephalus or osteogenesis imperfecta), using 6 or more pins.
Modifiers 22 (Increased Procedural Services) and 52 (Reduced Services) may apply. Other modifiers like 54 (Surgical Care Only), and 76-79 (Repeat Procedures) might be applicable in specific circumstances.
Medical necessity for 20664 is established when a patient with thin skull osteology requires cervical spine immobilization due to instability, fracture, or deformity. The documentation should clearly support the need for a cranial halo and the reason for using six or more pins with less force.
The physician preps and anesthetizes the patient, positions them supine, places the halo ring around the skull, inserts and tightens six or more pins, verifies alignment with imaging, and attaches the vest.
In simple words: A special head brace called a halo is attached to the skull with pins to protect the head and neck after an injury or surgery, especially in children with thin skulls. The halo is also attached to a vest for extra support. Removing the halo is included in this procedure.
This procedure involves the application and removal of a cranial halo device for patients with thin skull osteology, such as pediatric patients with hydrocephalus or osteogenesis imperfecta. The procedure requires the placement of six or more pins to secure the halo ring, utilizing less force to avoid skull damage.The halo is attached to a vest for stabilization. This code includes the removal of the halo.
Example 1: A pediatric patient with hydrocephalus requires stabilization of the cervical spine due to an unstable neck injury. A cranial halo is applied using six pins and attached to a vest., A child with osteogenesis imperfecta undergoes surgery for a cervical spine fracture.Due to their fragile skull, a halo application with six or more pins is performed for post-surgical immobilization., An infant with severe positional plagiocephaly and thin skull bones requires halo application for correction. Due to the skull fragility, more than six pins are used with reduced force for secure attachment.
Documentation should include the diagnosis necessitating halo application (e.g., hydrocephalus, osteogenesis imperfecta, fracture), the condition of the skull, the number of pins used, confirmation of cervical spine alignment via imaging, and the attachment of the vest.
- Global Days: 90 days
- Payment Status: Active
- Specialties:Neurosurgery, Orthopedic Surgery, Pediatric Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital