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Pin removal (20670 & 20680) during post-op period in office setting

  1. Red face Pin removal (20670 & 20680) during post-op period in office setting
    Medical Coding Books
    does anyone have experience with the following.
    i have received different view on the ability to bill for pin removal codes when removed in an office setting during the post-op period. please see article clips below.
    the initial surgery codes billed on 1 toe are:
    28285 - hammertoe correction
    28272 - capsulotomy metatarsophalangeal joint
    28270 - capsulotomy interphalangeal joint
    then the patient comes back within the post-op period and has the pin removed in the office. we have billed for this and been paid with the 58 modifier on the 20670 or 20680.

    my manager provided me 2 articles :

    -Code X-tra from american academy of orthopaedic surgeons 6/2005
    discussion: how do you bill for the removal of pins in the office setting during a global period when it is related to the procedure that is in post-op?
    answer: if the pins are removed in the office by the surgeon, the removal is not separately reportable. if pins are removed in the OR, append the appropriate (58 stagged, or 78 related) to the pin removal assuming no other procedure is performed at the same site.
    -Coding Corner by Mary LeGrand 1/2008
    can you code for pin or hardware removal that is performed in the office as part of the planned surgery?
    answer: removal of hardware placed by the surgeon is included in the planned surgery unless the pt returned to the OR for the removal, then append (58 or 78 modifier)
    Last edited by; 06-26-2009 at 08:39 AM.

  2. Default
    If they are just pulling the pin out in the office during the global, you do not bill. If the pt is taken back to the OR, you can use 20680-58. You can bill 20670 if the pin was placed by a different physician not in the same group practice.
    Ann Marie CPC
    Watertown, CT

  3. Default
    I've been told you cannot bill pin removal in the office during a post op period also. Only if pt is taken to OR, and apply modifier.

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