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Wiki SCREW ADVANCEMENT SURGERY HELP

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kkindle1807

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Belton, MO
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Can someone please assist with Coding this surgery. Physician stated that the bones settled as they fused from a prior surgery and one of the screws became prominent. He did another surgery with a plan to advance the screw or remove it based on what looked to be the least traumatic for the patient and the easiest and lowest risk wound up being to advance the screw several "mm", So it was an "arthrotomy and screw advancement", not a screw removal and not a "fusion procedure" as previously done. An incision was made, arthrotomy was performed between 3rd & 4th dorsal compartments, radiocarpal joint exposed. Fluoroscopy & dental pick was used to locate the screw and then it was advanced w/screwdriver. Maybe 25040? But not 20680 since screw was not taken out.
 
I would either code 25040 or maybe arthrodesis again with mod if still in global. Since there is no code for revision or advancement.
Another option is unlisted. Grey area for sure:)
 
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