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Hardware Removal Confusion

  1. Default Hardware Removal Confusion
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    Orthopedic surgeon removes hardware (consists of screw,washer & cable) from the right olecranon region. Do I use CPT code 20680 for the removal or 24160 (implant removal; elbow joint)? The Ingenix Coding Companion manual states to use 20670 or 20680 for removal of K-wire or pin. In looking at 20680 the implant examples are (buried wire, pin, screw, metal band, nail, rod or plate). What is the deciding factor on which CPT code is used 20680 or 24160? I'm confused on this & would appreciate any help. Thank you in advance.

    Jody Hecht

  2. #2
    Location
    San Antonio, Tx
    Posts
    73
    Default
    I would bill 24160 and 20680-59. They do not hit against eachother in CCI edits. If you have the Coding Companion, under 26140, it says to use 20670 or 20680 for removal of K-Wire or pin. 20670 is bundling with 24160. 20670 is for "superficial" implants. Just my two cents!
    Ray Galvez CPC

  3. #3
    Location
    Greater Pittsburgh
    Posts
    390
    Default
    I think it depends on the original surgery for the hardware, was it for a fracture (ORIF) repair 24685 (20680) or did the patient have an implant 24363 / 24666 (24160 or 24164).
    jdemar, CPC, CMA

  4. #4
    Location
    Piedmont Area Coders, VA
    Posts
    51
    Default I disagree...
    I respectfully disagree with the RGALVEZ.

    I would bill 20680 ONLY.

    My understanding is that 24160 is for removal if an arthroplasty-type joint implant (think total elbow).........

    Good Luck!

  5. #5
    Location
    Columbia, MO
    Posts
    12,560
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    I disagree with RGALVEZ as well it is one or the other but not both and if you are removing a screw then go with 20680.

    Debra A. Mitchell, MSPH, CPC-H

  6. Smile Thank You
    Thank you all for your responses & help. I think this site is great & so helpful to get the opinions & assistance of so many.

  7. #7
    Location
    Charm City - Baltimore
    Posts
    103
    Default
    I have also had this discussion.

    Here's how Medicare defines implant vs hardware:

    Implant replaces a body part. Screws, pins, plates and other fixation devices are considered hardware.

    I would use 20680 in this case.
    Crystal, CPC, CCS-P

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