Wiki remove & replace Cephalomedullary nail-femur

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RebeccaMoney

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What CPT(s)? They took out the lag screw and then placed a shorter lag screw. The locking mechanism for the helical blade was then engaged.
20680 & Unlisted(27599)? If so, what comparison code.
Thank you,
 
RebeccaMoney said:
What CPT(s)? They took out the lag screw and then placed a shorter lag screw. The locking mechanism for the helical blade was then engaged.
20680 & Unlisted(27599)? If so, what comparison code.
Thank you,
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Screw implant removal and replacement one month postop
CPT Assistant, November 2015 Page: 10 Category: Frequently Asked Questions

Frequently Asked Questions: Surgery: Musculoskeletal System

Question:

A patient had a screw implant placed approximately one month ago, as part of a caval varus foot reconstruction. The screw is in the subtalar joint. It is removed and replaced with a new shorter screw. How is the replacement of the screw reported?

Answer:

It is appropriate to report unlisted procedure code 28899, Unlisted procedure, foot or toes, for the screw replacement, and code 20680, Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate), for the removal, with modifier 78, Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period, appended for the revision of the original surgery. When reporting an unlisted code to describe a procedure or service, it is necessary to submit supporting documentation (eg, procedure report) along with the claim to provide an adequate description of the nature, extent, and need for the procedure; and the time, effort, and equipment necessary to provide the service.
 
Repeat procedure on nonunion fracture by another physician
CPT Assistant, September 2012 Page: 16 Category: Frequently Asked Questions

Surgery: Musculoskeletal System

Question:

Doctor Jones places deep hardware (anchors) and some Kirschner-wires (K-wires) for fracture treatment of carpal bones. Doctor Smith from a different practice evaluates the patient's now severely displaced, nonunion fracture with instability. Surgery is performed to stabilize and repair the nonunion wherein Doctor Smith must remove the previously placed hardware. May the removal of hardware be separately reported with code 20680?

Answer:

Yes. It is appropriate for Doctor Smith to report code 20680, Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate). In addition, the appropriate code for the nonunion repair may be reported with modifier 77, Repeat Procedure by Another Physician or Other Qualified Health Care Professional, appended.
 
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