# Removal/Replacement of screw in hip fracture



## brogdonlawn (Mar 20, 2012)

My doctor coded a 20670 but my research says that code can only be used if you are not replacing. The screws came loose causing painful bursitis type pain.  Took back to OR and took out the lag screw and measured and replaced the lag screw with a new one. What CPT code would be used. The original surgery was a 27245 for the rod that was used.


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## armen (Mar 21, 2012)

brogdonlawn said:


> My doctor coded a 20670 but my research says that code can only be used if you are not replacing. The screws came loose causing painful bursitis type pain.  Took back to OR and took out the lag screw and measured and replaced the lag screw with a new one. What CPT code would be used. The original surgery was a 27245 for the rod that was used.



Im not sure but what if its possible to use  20670 with 22 modifier? I would liove to see what others are thinking, did not have a situation like this before.


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## OCD_coder (Mar 25, 2012)

We use 20680-22 for these types of situations.  First, 20670 is "superficial" meaning it's for the removal of a pin or screw in the office requiring no incision or a teeny tiny incision to remove.  

This type of procedure is much deeper since it is in the hip and requires the patient to be put under anesthesia as they MD has to go very deep and it is very painful.  There is no CPT code for replacement of hardware.


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## armen (Mar 26, 2012)

mworcester said:


> We use 20680-22 for these types of situations.  First, 20670 is "superficial" meaning it's for the removal of a pin or screw in the office requiring no incision or a teeny tiny incision to remove.
> 
> This type of procedure is much deeper since it is in the hip and requires the patient to be put under anesthesia as they MD has to go very deep and it is very painful.  There is no CPT code for replacement of hardware.



I agree, I should have just suggested to use modifier 22. I just looked at the code in original post and got confused since it states MD coded 20670 I assumed the screw in fact was superficial unless that MD does not have a coding knowledge


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## kelley-ray (Oct 2, 2012)

*Removal and Replacement of lag screw hip*

I get that I would use 20680 for the removal of the lag screw, what code do I use for the replacement of the lag screw in the hip?


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