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20694 Removal Ext.Fixator in office under block?

  1. #1
    Question 20694 Removal Ext.Fixator in office under block?
    Medical Coding Books
    Can you charge for a 20694, removal of internal fixator device if it is removed in the office by our orthopedic surgeon under a hematoma block? (is that considered anesthesia?). He dictates a detailed report and states he removes the pins, dressings, etc.
    Or does this have to be performed in the hospital with general or mac anesthesia?
    Thanks so much for any help on this.

  2. #2
    From the CPT asst:

    CPT code 20694, Removal, under anesthesia, of external fixation system, may be reported if the removal procedure is performed under general anesthesia. General anesthesia is not usually required to remove an external fixation system, therefore, removal not requiring anesthesia is not a separately reportable service.

    Mary, CPC, COSC

  3. #3
    Question A hematoma block (analgesic) is not anesthesia?
    So, a hematoma block, (analgesic) is not considered anesthesia?
    The removal of this external fixation device is free if done in the office under a hematoma block?
    I know it is not included in the CPT code 20690, application.
    I am just trying to justify admitting the patients or doing this for nothing in the office?
    Thanks so much.
    Lynn, CPC

  4. #4
    Unfortunately when its done in the office, its considered part of the global surgical package, even with the block that is being given in your scenario.

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