CPT Code 20703

CPT code 20703 is for the removal of an implanted drug delivery device.

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What is CPT Code 20703

CPT code 20703 is for the removal of an implanted drug delivery device. This code is used when a healthcare provider surgically removes a device that was previously implanted to deliver medication directly to a specific area of the body.

Does CPT 20703 Need a Modifier?

When dealing with CPT code 20703 (Removal of implantable drug delivery device), it is essential to understand the potential modifiers that may be required to provide additional information about the procedure. Below is a list of modifiers that could be used with CPT code 20703, along with the reasons for their use:

1. Modifier 22 - Increased Procedural Services
- Use this modifier if the procedure required significantly more work than typically required. This could be due to complications or unusual circumstances.

2. Modifier 50 - Bilateral Procedure
- Apply this modifier if the procedure was performed on both sides of the body.

3. Modifier 51 - Multiple Procedures
- Use this modifier when multiple procedures are performed during the same surgical session.

4. Modifier 52 - Reduced Services
- This modifier is used when the procedure is partially reduced or eliminated at the physician's discretion.

5. Modifier 59 - Distinct Procedural Service
- Use this modifier to indicate that the procedure was distinct or independent from other services performed on the same day.

6. Modifier 76 - Repeat Procedure by Same Physician
- Apply this modifier if the same procedure is repeated by the same physician.

7. Modifier 77 - Repeat Procedure by Another Physician
- Use this modifier if the procedure is repeated by a different physician.

8. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period
- This modifier is used when the patient needs to return to the operating room for a related procedure during the postoperative period.

9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Apply this modifier if an unrelated procedure is performed by the same physician during the postoperative period.

10. Modifier 80 - Assistant Surgeon
- Use this modifier if an assistant surgeon is required during the procedure.

11. Modifier 81 - Minimum Assistant Surgeon
- Apply this modifier if a minimum assistant surgeon is required.

12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Use this modifier if an assistant surgeon is required because a qualified resident surgeon is not available.

13. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery
- This modifier is used when a physician assistant, nurse practitioner, or clinical nurse specialist assists in the surgery.

Each of these modifiers provides specific information that can affect billing and reimbursement, ensuring that the healthcare provider is accurately compensated for the services rendered.

CPT Code 20703 Medicare Reimbursement

CPT code 20703 pertains to the removal of an implanted drug delivery device. Whether Medicare reimburses this code depends on several factors, including the medical necessity of the procedure and the specific circumstances of the patient's condition. Generally, Medicare does cover the removal of implanted devices if deemed medically necessary by a healthcare provider.

As for the reimbursement amount, it can vary based on geographic location, the setting in which the procedure is performed (e.g., hospital outpatient department, ambulatory surgical center), and other factors. For the most accurate and up-to-date reimbursement rates, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS) or contact their Medicare Administrative Contractor (MAC).

In summary, CPT code 20703 is typically reimbursed by Medicare when medically necessary, but the exact reimbursement amount can vary. Always consult the latest MPFS or your Medicare Administrative Contractor for precise details.

Are You Being Underpaid for 20703 CPT Code?

Discover how MD Clarity's RevFind software can meticulously analyze your contracts and pinpoint underpayments down to the CPT code level, including specific codes like 20703 for the removal of an implanted drug delivery device. Ensure you're receiving the full reimbursement you deserve from each payer. Schedule a demo today to see RevFind in action and safeguard your revenue.

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