Wiki Need Help With Hardware Removal Code

KMECCA74

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Hi, I Am Trying To Find The Correct Code For Hardware Removal From An Ankle. I Am New To Asc Coding And Trying To Figure Out. Can Anyone Help Me?
Thanks
 
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
 
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.
 
Hardware Help

Thanks For Your Help, This Is Wonderful Support For Things Beyond My Specialty.:d
 
I too use 20680 for most hardware removals in an ASC setting such as pins, screws. 20694 says specifically for removal, under anesthesia, of external fixation system which is totally different.
 
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
 
I too use 20680 for most hardware removals in an ASC setting such as pins, screws. 20694 says specifically for removal, under anesthesia, of external fixation system which is totally different.
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.
 
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.
 
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.
 
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
 
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