Summary & Overview
CPT 20703: Removal of Intramedullary Drug Delivery Device
CPT code 20703 covers the surgical removal of a previously inserted intramedullary drug delivery device from the bone marrow canal when performed in conjunction with a primary procedure. This code captures a specific explantation service distinct from the primary operative procedure and is relevant to orthopedic and interventional specialists managing implanted drug delivery systems. Nationally, accurate use of this code supports precise procedure reporting, appropriate claims processing, and clinical documentation that differentiates device removal from primary surgical interventions.
Key payers in the national landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for device explantation, typical sites of service, and which payers are commonly involved. The publication outlines coding benchmarks, common modifiers reported with this service, and practical policy considerations that affect billing and claim adjudication. It also provides guidance on documentation elements typically expected to support the separate reporting of device removal alongside a primary procedure.
This summary is intended for a national audience of coding professionals, billing managers, and clinicians who need to distinguish this explantation service from primary surgical procedures and to align documentation and claim submission with payer expectations.
Billing Code Overview
CPT code 20703 describes the removal of a previously inserted intramedullary drug delivery device from the bone marrow canal of a bone when performed as part of a primary procedure. This service involves explantation of an intramedullary delivery system that had been placed within the medullary canal to administer medication directly into bone marrow.
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Service type: Surgical explantation of intramedullary drug delivery device
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Typical site of service: Inpatient or outpatient hospital operating room, ambulatory surgery center, or other facility capable of performing invasive orthopedic procedures
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with chronic intractable pain originally treated with an intramedullary drug delivery implant (such as an intramedullary pain pump catheter or medication reservoir) presents for removal of the implanted device as part of a primary operative procedure (for example, conversion to an alternative analgesic strategy or definitive device explantation due to infection, device malfunction, or therapy failure). The clinical workflow begins with preoperative evaluation including review of prior operative reports and imaging to localize the intramedullary device within the bone marrow canal. In the operating room under appropriate anesthesia, the surgical team identifies prior incision and implant tract, dissects to the bone, and removes the intramedullary drug delivery device from the medullary canal. Removal of the device is reported in addition to the primary procedure code(s) addressing the underlying condition (for example, debridement for infection, revision fixation, or conversion to another implant). Intraoperative documentation includes device identification, reason for removal, method of extraction, estimated blood loss, implants removed, and any complications. Postoperative care addresses wound management, antibiotic therapy if indicated, and pain control adjustments following device removal. Typical site of service is an inpatient operating room or ambulatory surgery center depending on clinical complexity and patient condition.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal or routine service |