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Wiki Hardware Removal - During a recent

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During a recent previous tibiotalocalcaneal arthrodesis the tip of one of the drill bits broke off. Due to the technical difficulty and concern for extended operation/tourniquet time the drill bit was left in.

Patient returns for removal of drill bit. Doc is saying 27640 partial excision bone tibia & 20680 hardware removal. I disagree. I am thinking more along the lines of 11044 & 20525.

. . .The draining sinus was excised in an elliptical fashion extending the incision proximally and distally. There was grayish reactive tissue all of which was debrided with a rongeur and a curette. This did go down to the level of bone. The broken drill bit, once I had started to get at this with the curette, virtually disintegrated. I was able to remove all of the metal debris and reactive tissue with rongeur and curette...

What do you think?
 
MFEDGE said:
During a recent previous tibiotalocalcaneal arthrodesis the tip of one of the drill bits broke off. Due to the technical difficulty and concern for extended operation/tourniquet time the drill bit was left in.

Patient returns for removal of drill bit. Doc is saying 27640 partial excision bone tibia & 20680 hardware removal. I disagree. I am thinking more along the lines of 11044 & 20525.

. . .The draining sinus was excised in an elliptical fashion extending the incision proximally and distally. There was grayish reactive tissue all of which was debrided with a rongeur and a curette. This did go down to the level of bone. The broken drill bit, once I had started to get at this with the curette, virtually disintegrated. I was able to remove all of the metal debris and reactive tissue with rongeur and curette...

What do you think?
Click to expand...

I would only use 20680 - any local debridement/excision of tissue in order to get to the hardware - is included.

He could put "22" mod on surg with documentation of additional time, effort it took ?
 
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