Wiki Removal of implant code 20670


Grand Rapids, MI
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From what I have found, 20670 is billable only if patient is taken back to the OR for removal of superficial implant. If this is done in the office during the fx care global period it is not billable. If removal is donein the office outside of the fx care global period then an e/m would be billed.

The information I found was from 2004, does anyone know if this is still accurate?

Thank you!
Mary Irvin, CPC
That is the same information I have as well, all our pin removals were rejected. We no longer do them in the office they are taken to the OR.
I heard a speaker a long time ago stated we need a mod-58 on the removal codes within the global period. As the MD has to remove the pin since they put it in and it's not typically considered part of the global description. Similar thoughts on the uniplane. We are getting paid for them this way.

We do not bill for carriers that follow MCR surgical guidelines.
Removal of superficial wires and pins, which means they are already sticking out of the skin, or palpable just underneath, rarely need more than just local anesthesia, and if done in the office, should be included in the global. Its part of aftercare, just as a change of dressings is.
The doc grabs the wire or pin with pliers and yanks it out. I don't see where a case can be made legitimately for scheduling a patient for this, unless perhaps you have a patient who is so anxious, like a small kid, for example, that its too hard to do. If you don't have anything like that, then don't bill it. If your doc is removing the pin or wire and he wasn't the one who put it in, then its ok to bill 20670. Sometimes its a fine line between 20670 and 20680. The end of the wire could be close to the skin, but it could be imbedded in bone and very hard to remove. You always want to use mod 58 if the carrier accepts it and it is within the global. I do hope the person whose doc takes every patient who has a superficial wire or pin, to the OR because it would be denied if done in the docs office has a talk with their doc about this practice. The doc would actually have to fabricate a reason to do that, and Medicare won't like that.
Removal of a uniplane ex-fix probably should be an OR procedure because there could be infection in the bone and more complex than it looks from the outside.