Wiki Can you bill a repair when you are removing hardware?

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Barbs63

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I have a patient, that doctor removed painful hardware in the ankle.
two separate incisions so I coded 20680 rt, 20680, 59 ,rt
The note states - prominent hardward was wearing through the deltoid, so when he removed the screw and washer - he repaired the deltoid.
Can I also bill 27698??
thanks in advance for your advice
 
20680 is used once per joint or anatomical area

I know 20680 is confusing. CMS came out with instructions in the NCCI POLICY MANUAL 2017. 20680 covers all hardware removal in any single joint or anatomic area. So look at your payer, if it is CMS or anyone who follows CMS policy, you would only be able to bill the code once.

If the payer is not CMS and does not follow their policy, you can give it a try.

Code 20680 is for the removal only, you can bill for a repair if something was rubbing against the hardware.
 
Thank you so much.
He did make two different incisions one over lateral and one over medial but this is a Medicare, am I still limited to only one 20680?
they are both clearly documentated.
 
You can only bill 20680 once per joint, per Medicare Surgical Policy Manual

Look at page #15 of the surgical policy manual CMS states " CMS allows one unit of service for all implants removed from an anatomic site...whether through one or more surgical incisions. An additional unit of service may be reported only if implants are removed from a distinct and separate anatomic site."
 
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