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Replacement of internal fixations

shelliet

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When a physician in a hospital setting removes and replaces fixation devices e.g. screws, pins, etc. can both the removal and the insertion of the new devices be coded or is this a bundled procedure?
 

todd5400

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Yes, they can. The removal has to be filed with a 51 modifier. Also, remember if they just adjust or fix the existing instrumentation there is procedure code 22849

Mary
 

mbort

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Yes, they can. The removal has to be filed with a 51 modifier. Also, remember if they just adjust or fix the existing instrumentation there is procedure code 22849

Mary
22849 is strictly for spinal procedures though. Is that what you are referring too Shelliet?

If you are talking about the 20680 then there are guidelines that state basically if you have to remove the old to put in the new, then NO its not seperately reportable.

Please provide a better example so that the forum can give you additional advice.
Thanks
Mary B, CPC,CPC-ORTHO
 

RebeccaWoodward*

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I had the priviledge of meeting one of the Neurosurgery guru's from Karen Zupko and Assoc. last week. She was in our office and I asked a question similar to this one; although, my question was related to spine. I wanted to confirm that removal and re-insertion at the same level would be coded with 22849. She did confirm that this was correct coding guidelines. Although there were other scenerios that could play out...this was the "watered down version". Any other thoughts/opinions?
 
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