I am no expert in ortho, but I do like a challenge.....
If you review 27620 -Arthrotomy, ankle, w/joint exploration, w or w/o bx, w or w/o removal of loose or foreign body. That last statement sums it up, you cannot charge for the "loose body removal" as the code includes it. Also, as far using 11044 - Debridement, skin, subcu tissue, muscle & bone; these debridement codes are not usually associated with fractures, usually used for infection of the skin that cause necrosis thru the layers, sometime down to the bone, etc... anyone can correct me if I am wrong, but it's not an appropriate use. With regards to 20694, it's questionable, I work ENT, when we have to replace pressurizing tubes in a patient's ears, we cannot charge for the removal of the old tubes; I know the comparison is extreme, but the principle is the same, hence the bundling; if you are removing the hardware only, you charge for it, if you are removing and replacing, you do not charge for the removal.
Hope this helps......
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