Wiki Harware removal

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Can anyone direct me to the guidelines that state hardware removal cannot be separately coded, if the removal was necessary to perform another procedure? I need to show something to our surgeons who claim this is a separate procedure and billable.
Thanks!
 
Loree Morris RN, CPC

The AAOS issued a Coder's Pink Sheet May 1, 2004 which states "CMS,AAOS and AMA all agree that when the procedure is part of another larger procedure, you don't bill 20680 at all, it's included in the global payment Correct Coding Initiative. This is spelled out in the NCCI policy chapter 4, section D, fractures" Also CPT Assistant gives an example of a case of hardware removal that was difficult but still not billable it was CPT Assistant March 1992 I do not have further reference on that one but if you have computer access to CPT Assistant you can do a search and it should bring it up. The AAOS Pink sheet however has quite a bit information in it about hardware removal and how to code and bill it. The AAOS also put out a bulletin in June 2004 with more information on hardware removal if you can get that from the AAOS. Here is the web for that: http://www.aaos.org/wordhtml/bulletin/jun04/code.htm
 
7. There are CPT codes (20670 and 20680) for removal of internal fixation devices (e.g., pin, rod). These codes are not separately reportable if the removal is performed as a necessary integral component of another procedure. For example, if revision of an open fracture repair for nonunion or malunion of bone requires removal of a previously inserted pin, CPT code 20670 or 20680 is not separately reportable

http://www.cms.hhs.gov/NationalCorrectCodInitEd/

Click on NCCI Policy Manual-Open PDF Chapter 4
 
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