Answer ORIF femoral shaft fracture w/ removal of previous hardware billable as 27506-22?

cliff.chen89

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Our MD performed an ORIF femoral shaft fracture w/ removal of previous hardware. The NCCI edits bundled 27506 & 20680. Would I be able to bill 27506 w/ a modifier 22 given the extra work/time?
 

Orthocoderpgu

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If removing hardware is necessary in order to perform another procedure, the removal of the hardware is included and would not be billed, and modifier -22 would not be used. If your surgeon experienced extreme difficulty removing the hardware, and that difficulty is well documented, then I would with the understanding the insurance may not pay extra. But if was normal hardware removal, it's bundled. Examples of when modifier might be appropriate. I have had bone grow over screws that secured the hardware and the surgeon had to take a lot of extra time and effort in order to remove the screws. I had one where it took the surgeon four hours and calling in two associates before they could get the hardware removed. Your looking for those situations in order to use -22.
 
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