operation question...stumped..help!


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I am a newbie at ortho and am having some trouble coding a surgery, any help would be appreciated. I have:

1)ORIF right elbow painful olecranon osteotomy non-union
2)Hardware removal right distal humerus fracture
3)Hardware right elbow olecranon
4)Fluoroscopic guidence ORIF right elbow olecranon osteotomy non-union

#1 is really stumping me...I have 20680-59 for the hardware removal but do I use it twice since it is the same area of the body? Please advise on that one and do I have the 77002-26 59 right for the Fluoro?

Thank you
I would use 24685
20680 51

The 77002 is for use only on needle guidance, eg. epi injections.
Usually fluoro is not payable by any payor so I would not add a mod just know when pmt comes in, if fluoro is not pd don't appeal. HWR would only be billed once since it is in the same area, possibilty it won't be pd either. Hope this helped.
yes it did! thank you! I actually had the same code you gave me picked out.

Thanks again!
to set the record straight

Just wanted to let you know that after talking with the doctor on this one I actually coded it as:

25400-repair of nonunion ulna
20680-51-hardware removal unlna
76000-26 51

I had thought he was actually doing the ORIF but after talking with him further he wasn't.

Thanks again! It's nice to have the support system out there.