# Ex fix removal with delayed ORIF



## aalley (Oct 9, 2012)

What are your thoughts on billing for removal of an external fixator along with an ORIF?  The ex fix was put on as initial treatment and now a week and a half later it is being removed and the fracture is being repaired with internal fixation. Just not sure if this would be considered a componant of the ORIF approach.


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## nyyankees (Oct 10, 2012)

aalley said:


> What are your thoughts on billing for removal of an external fixator along with an ORIF?  The ex fix was put on as initial treatment and now a week and a half later it is being removed and the fracture is being repaired with internal fixation. Just not sure if this would be considered a componant of the ORIF approach.



Sounds like a staged (Mod 58) procedure. So I would think you could bill the removal along with the ORIF.


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## jdemar (Oct 10, 2012)

Yes, bill it with modifiers 58,51 and the ORIF.


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## Kimberly Smith (Oct 10, 2012)

I agree. For instance GSD for 27507 excludes application of external fixation so if you are coding removal under anesthesia with ORIF it would be reportable with 58.


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