2025 CPT code 20802

Replantation of a completely amputated arm, from the surgical neck of the humerus to the elbow joint.

Adhere to the current CPT guidelines for reporting replantation procedures.Use appropriate modifiers to accurately reflect the surgical procedures performed.Document all services rendered meticulously to support medical necessity.

Modifiers 51 (multiple procedures), 59 (distinct procedural service), and 76 (repeat procedure) may be applicable depending on the circumstances of the case.Consult the CPT manual for detailed modifier application guidelines.

Medical necessity for replantation is based on the potential for functional recovery and the overall improvement in the patient's quality of life compared to the use of a prosthesis. Factors considered include the patient's age, the level of amputation, the condition of the amputated limb, and the patient's overall health.

The clinical responsibility for this procedure lies with a surgeon specializing in microsurgery and hand surgery or a trauma surgeon with expertise in limb replantation.This includes pre-operative assessment, surgical technique, and post-operative care including managing complications and ensuring optimal healing.

IMPORTANT Other CPT codes (20803-20838) exist for replantation of other extremities (e.g., forearm, hand, fingers).For replantation procedures not specifically listed, code 20999 (Unlisted procedure, musculoskeletal system, general) may be used.Consider using appropriate modifiers (e.g., 51 for multiple procedures, 59 for distinct procedural services) as needed.

In simple words: The doctor reattaches a completely severed arm, from the upper arm bone to the elbow. This major surgery involves carefully cleaning the wound, connecting bones, blood vessels, nerves, and then closing the skin.It might need skin grafts if there's a lot of damage.

This CPT code 20802 encompasses the surgical reattachment of a completely amputated arm, specifically from the surgical neck of the humerus to the elbow joint. The procedure involves meticulous preparation of both the amputated arm and the patient's residual limb.This includes debridement of damaged tissues, identification and tagging of arteries, veins, and nerves, and alignment of the bone structures.Bone fixation is typically achieved using plates or pins.Microvascular anastomosis is performed to reconnect the blood vessels, ensuring adequate blood supply to the replanted arm.Nerve repair is also conducted to restore nerve function. Finally, the skin and soft tissues are closed, often requiring skin grafts or flaps in cases of significant tissue loss. Postoperative X-rays are obtained for confirmation of alignment.

Example 1: A 30-year-old male construction worker suffers a complete traumatic amputation of his right arm above the elbow in a workplace accident.The amputated limb is immediately recovered and transported to the hospital with the patient.After thorough evaluation, the surgeon performs a replantation using code 20802, with the need for significant vascular repair., A 25-year-old female sustains a complete amputation of her left arm at the mid-humerus level in a motor vehicle accident.The amputated arm is transported to the hospital on ice along with the patient.The surgery involves extensive bone, vascular, and nerve repair, necessitating the use of code 20802., A 16-year-old male experiences a complete traumatic amputation of his right arm just below the surgical neck of the humerus due to a farm accident.The arm is transported to the hospital with the patient. The surgical procedure included replantation of the arm (20802), along with multiple tendon repairs (requiring modifier 51), and skin grafting, which are coded separately.

Detailed operative notes describing the surgical technique, including bone fixation method, vascular anastomoses (including vessel diameters), nerve repair details, and type of skin closure.Preoperative images and assessment of the amputated limb, including documentation of vascular viability.Postoperative X-rays to confirm bone alignment.Complete medical history, including information about smoking status.Follow-up notes documenting the patient's recovery, complications management, and functional outcomes.

** The complexity of the procedure and associated reimbursement will vary based on factors such as the extent of tissue damage, the length of the surgical time, and the need for additional procedures such as bone grafting, tendon repair, and skin grafting. Always consult with the surgeon to clarify the specific components of the procedure performed and their associated billing implications.Be aware of payer-specific guidelines and coverage policies, which may impact reimbursement.

  • Revenue Code: P3D (MAJOR PROCEDURE, ORTHOPEDIC - OTHER)
  • RVU: The relative value units (RVUs) for this code vary depending on the geographic location, facility type, and other factors. Consult a fee schedule or pricing database for specific RVU values and reimbursement rates.
  • Global Days : The global surgical period for this procedure is typically extended, likely covering several weeks to months of postoperative care for follow-up appointments, wound monitoring, and potential complications management.
  • Payment Status: Active
  • Modifier TC rule: The use of Technical Component (TC) modifiers is usually not applicable to this procedure code because it directly describes the physician's work during surgery.
  • Fee Schedule : Historical fee schedule data for CPT code 20802 varies depending on the payer and year.Consult fee schedule databases or pricing resources for specific historical data.
  • Specialties:Orthopedic Surgery, Plastic Surgery, Microsurgery, Trauma Surgery
  • Place of Service:Inpatient Hospital, Ambulatory Surgical Center
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