Orthopedic Coding Alert
Removal of Multiple Hardware, One Site
Cherie Aloisio
Kennedy-White Orthopaedic Center, Sarasota, Fla.
Answer: It is inappropriate to charge for removal of multiple pieces of hardware through one incision in one anatomic site, says Catherine Brink, CMM, CPC, president of HealthCare Resource Management, Spring Lake, N.J. However, code 20680 (removal of implant; deep [e.g. buried wire, pin screw, metal band, nail, rod or plate]) is a unilateral procedure. If performed bilaterally, left and right legs for example, code 20680 would be billed twice. Append -50 (bilateral procedure) to the second code.
If removal of a screw was performed in two different metatarsals with two separate incisions, code 20680 could be billed twice with the -59 modifier (distinct procedural service) on the second listed 20680 code.
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