Wiki 2nd request-hardware removal

[Snflwr]

My physician removed hardware from an ankle by 2 seperate incisions of which I know I can only use 20680 once but he also wants to charge for exploration of the tib post tendon, op note states...

I extended the incision distally from the tib post tendonn and passed a hemostat up the sheath and identified it more proximally where the plate had been close to it. There was some minor abrasion involoving 5-10% of the tendon but the great majority of it was intact. I debided this small area and then thoroughly irrigated, clodes the subcu....

I looking at this a debridment that had to do with the hardware so it would be bundled. Can he charge for this and if so I have no idea as to what code I would be looking for. Thanks

 

[risnerclan]

so he made 2 seperate incisions and removed hardware twice? was it like a bimalleolar fx? if he made 2 seperate incisions and removed different hardware from both incisions i have always been told you can bill it.

 

[jenkins62]

I agree with previous post..

If removal of im nail and screws through multipile incisions may be made to remove screws and plate 20680 x 1

but if pt has tibial plateau and tibial shaft fracture, 20680 may be reported twice because the fractures are:

1. Non-continguous and
2. Were fixed with 2 separate plating systems..

Add modifer 22 to cpt if there is documentation of extraordinary amount of work, or unusual effort in the removal of the hardware.

Hope this helps...