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Thread: 27447 and 20680

  1. #1

    Default 27447 and 20680

    AAPC: Back to School
    One of my drs did a total knee(27447) and a removal of hardware specificaly from a seperate incision(20680). I billed both codes adding a 59 modifier on 20680. the insurance is denying 20680 disregarding the 59 modifier and the fact that it was removed from a seperate incision. I wanted to make sure that this was still allowed to be billed together, as it was a seperate incision. If so, can anyone guide me to any documentation that states this

  2. #2


    As far as I know, 20680 cannot be reported separately if it is performed as a necessary integral part of another procedure (Medicare NCCI Policy Manual for Medicare Services, Chapter 4 (Surgery: Musculoskeletal System CPT Codes 20000-29999), item #8 under section F. - Fractures and/or Dislocations). If you find out otherwise, please let me know.


  3. #3


    If he needed to remove the fixation before he could perform the knee replacement, it would be included.


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