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Guest
#1 Posted : Friday, January 4, 2019 5:33:12 PM(UTC)
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Guest

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Hello,

I work for an Oral and Maxillofacial Surgeon that has seen a recent increase in BAMPS (bone anchored maxillary protraction) procedures. For this procedure he installs 4 Bollard Mini Plates (with screws) in order to bring the top jaw forward. I'm lost as to how to code this because we feel it should be covered under medical due to the congenital nature of the issue! We also have a "D" code for the medical device, but I'm being told that I should code this procedure using 20650 but that we can't be reimbursed for the plates/screws.

One last question, if the 20650 is the correct code, in my research I'm seeing that this CPT code doesn't apply to modifier 51, is that payer specific or is that a general rule for this code?

Thank you so much for your help!
courtneydsnow
#2 Posted : Tuesday, January 8, 2019 12:43:18 PM(UTC)
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courtneydsnow

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Hi Guest!

20650 stands for: Insertion of wire or pin with application of skeletal traction, including removal

Out of curiosity - what "D" code are you using for the medical device?

As far as modifier 51 - i would think that it would be situational for use depending on what all procedures the patient has performed on the date of service.
Guest
#3 Posted : Wednesday, January 9, 2019 12:32:33 PM(UTC)
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The Medical Device Code starts with a D - this is the "D" code I was referencing, in order to determine if we can list the medical device code and attach the statement showing the cost of the plates, in order to receive reimbursement for the hardware.

And based upon the code description, a plate wouldn't classify as a wire or pin, so would it be best to use CPT code 21299 and submit the documentation with the claim?
courtneydsnow
#4 Posted : Friday, January 18, 2019 2:21:04 PM(UTC)
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courtneydsnow

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Hi guest!

Yes based on what you're describing, 21299 does sound like a good option, as there is not a specific CPT i am aware of for the procedure you're describing. As you mentioned, a narrative report describing the procedure to accompany the claim would be highly recommended! :)
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