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Wiki Need Help With Hardware Removal Code
- Thread starter KMECCA74
- Start date
ohiocoder101
Guru
Hi, i have just recently been coding for orthopedic surgeries, i am a cpc for anesthesia. I have 2 codes that would help you, one would be: V54.01 or 996.7x--this one would be for other complications of internal, prosthetic device, implant, and graft. Now if your looking for the CPT code, it would be:20694.
Hope these help....if you need anything else, please do not hesitate to contact me
Hope these help....if you need anything else, please do not hesitate to contact me
mbort
True Blue
If the only procedure being performed in the ASC is "hardware removal" of the ankle, then it is billable/codable and not inclusive. If another procedure is performed as well, then I would double check the CCI edits prior to using. The most common CPT for hardware removal is 20680.
amitjoshi4
Guru
- Messages
- 113
- Best answers
- 0
Look for these codes 27704 for implant removal ankle. Implants are also a type of Hardware. It is a straight code which we can use here. Another scenario is to go with 20670 or 20680 depending upon the superficial and deep nature. Screws are always deep. Pin , Rods and Wires can be both. Look at the type of incision and the embedded nature of Hardware.
Thank You
Thank You
GKS*dec21
New
I am uncertain if this code 20680 can be charged with units or not? The CPT description reads singular. I can not find any reference for this.
mbort
True Blue
Here is some info on 20680 for you taken from the AAOS website
http://www2.aaos.org/aaos/archives/bulletin/jun04/code.htm
Hardware removal
Q: The patient had a bimalleolar ORIF and, for whatever reason, a year or two later the physician removes the hardware. There are two plates and eight screws (four screws in each plate). Do you report:
• 20680x10 for the two plates and eight screws?
• 20680 just once because it is considered one internal device that was placed?
• 20680x2 because you made two incisions to remove?
A: Based on a discussion by the AAOS ICD-9 and CPT Coding Committee, removal of hardware used for a specific fracture type—regardless of the number of screws, plates, rods or incisions—would only be coded once. If there was an extraordinary of work involved (e.g., bone-buried screws, exceptional scar), then modifier -22 would be added with the usual accompanying note.
Multiple use of 20680 would only be appropriate when the hardware removal was for another fracture unrelated to the first fracture (e.g.,ankle and humerus). Then modifier -59 would be used.
http://www2.aaos.org/aaos/archives/bulletin/jun04/code.htm
Hardware removal
Q: The patient had a bimalleolar ORIF and, for whatever reason, a year or two later the physician removes the hardware. There are two plates and eight screws (four screws in each plate). Do you report:
• 20680x10 for the two plates and eight screws?
• 20680 just once because it is considered one internal device that was placed?
• 20680x2 because you made two incisions to remove?
A: Based on a discussion by the AAOS ICD-9 and CPT Coding Committee, removal of hardware used for a specific fracture type—regardless of the number of screws, plates, rods or incisions—would only be coded once. If there was an extraordinary of work involved (e.g., bone-buried screws, exceptional scar), then modifier -22 would be added with the usual accompanying note.
Multiple use of 20680 would only be appropriate when the hardware removal was for another fracture unrelated to the first fracture (e.g.,ankle and humerus). Then modifier -59 would be used.
Cmay73
New
20680-50
I have a pt that had bilateral hip hardware removal. He had bilateral total hip arthroplasties for avascular necrosis in the past. I used 20680-50, but Medicare is denying do to "modifier being inconsistant with modifier." How would I bill this? I thought maybe 20680 and 20680-59 but not sure. Any help would be appreciated.
Thank you.
I have a pt that had bilateral hip hardware removal. He had bilateral total hip arthroplasties for avascular necrosis in the past. I used 20680-50, but Medicare is denying do to "modifier being inconsistant with modifier." How would I bill this? I thought maybe 20680 and 20680-59 but not sure. Any help would be appreciated.
Thank you.
Cmay73
New
20680-50 mod
I think I found my answer in the CCI guidelines. Charge 20680 and 20680-59. If someone thinks that may be incorrect please let me know.
Thank you
I think I found my answer in the CCI guidelines. Charge 20680 and 20680-59. If someone thinks that may be incorrect please let me know.
Thank you
AM4255
New
The procedure code for removal of hardware from ankles is different. I've been to so many ankle and foot conferences and almost all the seminars state Orthopedic coding allows you to bill with the code 27704 for Ankle implant removal. That code must be used instead of 20670 or 20680, EXCEPT for example; if only two screws or a couple pins are removed, then it’s not considered an extensive procedure and thus 20670 and 20680 codes are applicable. Whereas 27704 can be billed for beyond removal of a few screws or pins. 27704 also is a higher paying code than 20680, so its best to remember to use that code when doing ankle hardware removals so you aren't missing out on revenue.
There is also site specific coding for the finger as well, 26320. Same scenario applies as that for 27704. HOWEVER, fee schedule for 26320 is lower than that of 20680, so 26320 is not a favored code among orthopedic coders since that specific code is supposed to contain more work involved than that of a 20670 or 20680.
I've been billing out 27704 the past 6 years at my current practice, never had a denial and have come back green flagged when Medicare audits for the operative report later down the road.
There is also site specific coding for the finger as well, 26320. Same scenario applies as that for 27704. HOWEVER, fee schedule for 26320 is lower than that of 20680, so 26320 is not a favored code among orthopedic coders since that specific code is supposed to contain more work involved than that of a 20670 or 20680.
I've been billing out 27704 the past 6 years at my current practice, never had a denial and have come back green flagged when Medicare audits for the operative report later down the road.
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