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Replacement of internal fixations

  1. Default Replacement of internal fixations
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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?

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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

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    Quote Originally Posted by todd5400 View Post
    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

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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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