Strut changes?

mksmith713

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Does anyone know if struts are includied in the 20697 code or is there a seperate code for the billing of the strut?
 

Bella Cullen

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20697 is for removal and replacement of each strut. So I would say there is not a separate code.
 

mksmith713

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So the cost of the strut is included in this code?

Just wanted to clarify because I'm not finding anything written that specifically states whether the strut is inclusive.
Most of the CPT I use don't include supplies.
They have a separate L,J or Q code in addition to the CPT code.

I do about 30-35 strut changes a week and have to figure out how to code this properly.
 

Bella Cullen

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So the cost of the strut is included in this code?

Just wanted to clarify because I'm not finding anything written that specifically states whether the strut is inclusive.
Most of the CPT I use don't include supplies.
They have a separate L,J or Q code in addition to the CPT code.

I do about 30-35 strut changes a week and have to figure out how to code this properly.
Yeah I would say it is included because for that code it specifically says your removing one strut and replacing it with another strut at the same time.
If it just said removal of strut then I would say there should be another code for the placement, but this code includes the placement.
Pretty much its an even exchange.
I hope I explained it good. :)
 

mksmith713

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I can see where you're coming from but the reason I'm questioning whether the strut is inclusive is because I have other procedures I code where everything is seperately coded...for example..... 15002,15400 and Q-4102
If you look it up, 15400 says,"xenograft,skin (dermal), for temporary wound closure,trunk,arms,legs, first 100 sq cm or less.
This (15400) is the code I for the application of the xenograft,not the xenograft itself. I also code FOR the xenograft itself with Q-4102 per sq cm.

So, can you see where I'm questioning the strut change code?
It's not totally out of the question that the strut itself may be seperately coded.
 
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So, do you need a SUPPLY code?

MK ... I don't have the answer to your question, but ...

Are you asking for is the supply code for the strut, and whether that is separately billable?

F Tessa Bartels, CPC, CEMC
 

mksmith713

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I'm asking whether 20697 is the CPT code for the removal and replacement of the strut (procedure) only....
and is there a seperate HCPCS code for the strut itself?
or is the strut included in the 20697 CPT code?
 

mbort

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The only way you can capture this is IF your office actually purchased the strut fromthe vendor and carried it to the operating room. Usually the vendors supply the facilities with these. The facilities pay for them and charge out to the carrier.
 

mksmith713

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We do the strut changes in the clinic.
No anesthesia, no facilities fee.
Usually part of a follow up visit but not always.


On another note.
What if a patient comes in for a follow up and requires full modification of their turning schedule?
This happens often enough for me to inquire.
It requires going into Smith & Nephew's TSF website and time consuming input of parameters to produce a new turning schedule.
 

mksmith713

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The only way you can capture this is IF your office actually purchased the strut fromthe vendor and carried it to the operating room. Usually the vendors supply the facilities with these. The facilities pay for them and charge out to the carrier.
WE still haven't established IF the cost of the strut is inclusive of the CPT code.

I see nothing in the description that says the stut is included in the procedure.

Assuming the strut is included it like assuming the guy you buy your new tires from is including the valve stems mounting and balancing.
That usually costs extra.

Sorry guys,......I love analogies......:eek:
 

mbort

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The cost of the supply is not included in the CPT. Since your office is purchasing the supply, you may bill it with the appropriate HCPCS code to the carrier
 

mksmith713

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Back to (part of) my original question.
Does anyone know what the HCPCS code is for the strut?
and...are you ABSOLUTELY SURE the strut isn't included in the CPT code?
I'd love to know where I can find this info in black and white.
Being a new code, I can understand it not being etched in stone but I'm sure there has to be some reference to the new codes somewhere.
 

mksmith713

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L-8699? That's the unlisted code for an implant.
Struts aren't implantable.

I think this is going to be one of those cases where I'm going to cause headaches for everyone involved.

I'll see if our billers will bill it as unlisted and see what kind of trouble it stirs up.
 

Jsillaway

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Strut changes on a Taylor spatial frame

My doc is doing a strut change for leg length discrepancy which is 20697, is there a HCPCS code for the actual Strut?
 
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