2025 CPT code 20805
(Active) Effective Date: N/A Revision Date: N/A Surgery - Replantation Musculoskeletal System Feed
Replantation of a completely amputated forearm, including radius and ulna to the radial carpal joint.
Modifiers 51 (multiple procedures), 59 (distinct procedural service), 76 (repeat procedure) and others may be applicable depending on the circumstances of the case.Always refer to the most recent CPT guidelines.
Medical necessity for replantation depends on factors such as patient age, overall health, the level of amputation, functional potential of the replant, and patient preference. Replantation is generally considered medically necessary when it offers a reasonable chance of restoring significant function and improving quality of life.
The surgeon's responsibilities include wound preparation, assessment of the amputated limb, debridement, identification and repair of blood vessels (arteries and veins) and nerves, bone fixation (e.g., using plates and screws), tendon repair, and skin closure (possibly with grafts or flaps). Post-operative care is also part of the global surgical period.
In simple words: This is a major surgery to reattach a completely severed forearm. The doctor will reconnect the bones, blood vessels, nerves, and tendons to reattach the arm.Skin grafts may be needed.
Replantation of a completely amputated forearm involves reattaching the severed limb at the radial carpal joint.The procedure includes the radius and ulna bones.It necessitates meticulous reconnection of arteries, veins, nerves, tendons, and bones, often requiring microvascular anastomosis and bone fixation.Extensive debridement, skin grafting or flap procedures may be necessary to address tissue damage and ensure wound closure.
Example 1: A 35-year-old male factory worker suffers a complete forearm amputation in a workplace accident. The forearm is successfully reattached via replantation surgery., A 10-year-old boy has a complete forearm amputation due to a traumatic injury.Replantation is attempted, involving bone fixation, vascular anastomosis, nerve repair, and skin grafting., A 40-year-old female sustains a complete forearm amputation in a motor vehicle accident. Replantation is performed, requiring extensive microsurgical techniques to reconnect blood vessels and nerves. Extensive debridement is performed prior to reattachment.
Detailed operative report including all structures repaired (bone, vessels, nerves, tendons), type of fixation, and any grafts or flaps used. Pre-operative and post-operative imaging (X-rays), anesthesia records, pathology reports if tissue was sent for analysis.Detailed description of the injury and the replantation process.Documentation of the patient's progress during the 90-day global period.
** The complexity of the replantation will determine the level of resources and time required.The patient's age, overall health, and the condition of the amputated limb will impact the prognosis and the medical necessity for the procedure.
- Revenue Code: P3D (MAJOR PROCEDURE, ORTHOPEDIC - OTHER)
- RVU: This information is not provided in the source.RVUs vary based on geographic location and other factors. Consult a relevant fee schedule for the most accurate information.
- Global Days : The global period for this procedure is 90 days post-operation.All related post-operative care (visits, dressing changes, suture removal, etc.) within this period are included in the code.
- Payment Status: Active
- Modifier TC rule: Not applicable. This is a complete surgical procedure.
- Fee Schedule : Fee schedules vary by payer and location. Historical fee data can be obtained from various sources such as the Centers for MedicareMedicaid Services (CMS) or private payers' websites.Note that historical data should not be used for current billing.
- Specialties:Orthopedic Surgery, Plastic Surgery, Microsurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center