# screw exchange



## taurus7694 (May 22, 2009)

Can anyone help me with a code for syndesmotic screw exchange?  Our doctor took patient in to remove screw from ankle and replace it with another one..same spot.

Thanks


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## Bella Cullen (May 27, 2009)

There is not a code for replacement or placement of a screw so you would have to use unlisted with the fee from 20670 or 20680.


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## Lliza71 (May 29, 2009)

*syndesmotic screw exchange*

Hi Taurus,
My doc just did the same thing last week.  He took pt in to remove and then replace screw for bigger size.

I coded as Hardware removal only (20680) because you can't bill for internal fixations separately.  They're usually included. Our lead coder here agreed. The haredware removal isn't inclusive to anything else so u can bill.
It's too early to know how the ins co will pay, but that's my thougths on it.

Good luck!
Liza


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## Bella Cullen (May 29, 2009)

Lliza71 said:


> Hi Taurus,
> My doc just did the same thing last week.  He took pt in to remove and then replace screw for bigger size.
> 
> I coded as Hardware removal only (20680) because you can't bill for internal fixations separately.  They're usually included. Our lead coder here agreed. The haredware removal isn't inclusive to anything else so u can bill.
> ...



The only thing about that is what happens if this new pin or screw needs to be replaced? You can't keep coding removal. That is why I use unlisted code and use the fee from 20680.


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## taurus7694 (Jun 1, 2009)

Thanks for the advice.  I think we have coded this in the past with just the 20680, and I believe we will this time as well.  Thanks again for all the responses.


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