AAPC - Back to school
Results 1 to 5 of 5

Thread: Removal of Hardware

  1. #1
    Join Date
    Apr 2007
    Grand Canyon Phoenix

    Default Removal of Hardware

    AAPC: Back to School
    All you orthopedic guru's I need some clarification.

    Truama patient taken to surgery for an ORIF of distal radius with plates and screws by othro on call. Referred to my surgeon the hand specialists. My surgeon finds a "NEW" fracture distal to the plate. My surgeon has to remove the original plate "not put in by him" and replace with longer plate to cover now both fractures. We coded removal of hardware because we did not put the hardware in and ORIF of the "new" fracture. I am being denied the removal stating it does not matter who put the original plate in all is global. I do not agree!! Any thoughts???

    Signed Upset

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default Modifier

    This is NOT my area of expertise, but ...

    Did you use any modifier? I would have put a -59 on the hardware removal to indicate that it was a separate proceduure from the fracture treatment.

    If the payor is adamant about the hardware removal being included, then you might want to consider adding -22 modifier to the basic fracture treatment code, and increasing your fee by X% for the added difficulty / time this took over and above the usual procedure.

    Just my thoughts ...

    F Tessa Bartels, CPC, CPC-E/M

  3. #3
    Join Date
    Apr 2007


    What code did you bill for the ORIF of the new fracture? I checked the edits for 25607, 25608, & 25609 and none of them show to have 20680 bundled.
    Eileen Blankenship, CPC
    Remote Coder

  4. #4
    Join Date
    Apr 2007
    Madison Area Chapter in Madison WI


    My understanding is the removal of the original hardware is considered part of the second hardware procedure. You can't do the replacement without removal of the original. Because it is much harder and takes more time, resources, etc to remove the hardware prior to the replacement, the 22 modifier is appropriate. I apologize because I don't recall where this is documented. I think it was in a CPT Assistant. Does anyone have anything to support this logic?
    Happy Coding, Claudia

    Claudia Yoakum-Watson, CPC
    Coding, Compliance, & Reimbursement Solutions
    ccrsconsulting.com - website

  5. #5
    Join Date
    Apr 2007


    I agree with Claudia and FTessa. Unfortunately you will not be able to capture for the removal on its own, so I would do a corrected claim with the 22 modifier and send the documentation to support it,

Similar Threads

  1. removal of hardware and replace hardware
    By 574coding in forum Orthopaedics
    Replies: 1
    Last Post: 07-15-2015, 06:41 AM
  2. Hardware removal???
    By Amzie in forum Orthopaedics
    Replies: 3
    Last Post: 04-10-2012, 05:27 AM
  3. Hardware removal with new hardware implantation
    By ammontagano in forum Orthopaedics
    Replies: 1
    Last Post: 11-16-2010, 09:03 AM
  4. Hardware removal with reimplantation of hardware
    By gsteeves in forum Orthopaedics
    Replies: 5
    Last Post: 05-14-2009, 02:01 PM
  5. Removal of hardware
    By cbheusman in forum Orthopaedics
    Replies: 3
    Last Post: 12-02-2008, 01:51 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.