# removal of bone - I'm billing for



## BFAITHFUL (Mar 6, 2011)

I'm billing for an ASC.  What is the correct cpt code to use for removal of bone stimulator.  CPT 20680 or the unlisted code?

Thank you


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## msrd_081002 (Mar 6, 2011)

*20974 or 20975*



BFAITHFUL said:


> I'm billing for an ASC.  What is the correct cpt code to use for removal of bone stimulator.  CPT 20680 or the unlisted code?
> 
> Thank you



If *in*vasive      -20975
If *non*invasive -20974

*IF* Medicare-mandatory to have *V45.4* as one of the codes for 20975 per CMS.


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## BFAITHFUL (Mar 7, 2011)

*bone stimulator removal*

That's the code for insertion of bone stimulator.... I need the code for "Removal" ?


Thanks!


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## MMAYCOCK (Mar 7, 2011)

BFAITHFUL said:


> That's the code for insertion of bone stimulator.... I need the code for "Removal" ?
> 
> 
> Thanks!


My understanding of 20680 is that it is for "permanent" implants that for whatever reason needed to be removed, but I cannot find any documentation that specifically states this other than the examples given in CPT. 
The other removal codes - 63688, 64595, 63661, 63662 are all for neurostimulator or pulse stimulator removal, so everything I read leads me back to the unlisted code. 
I would be very interested in finding out how you bill it and what the results are if you don't mind.


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## BFAITHFUL (Mar 7, 2011)

Below is the response I got from our audit company.... they have a great reputation they're from ACE (Devona Slater's) company.    


"When the implantable bone growth stimulator is placed at the time of the spinal fusion surgery the CPT code 20975 would be reported separately. The implanted device is quite small and placed in a small pocket of tissue under the skin in the back. 

The implanted device may be removed at the end of its useful life. When the device is removed you would code the service for removal foreign body, subcutaneous tissues with either CPT 10120-10121, depending on the documentation"

It is based on the original procedure when the unit is placed. As explained below the unit is placed in a pocket below the skin in the back. There is no other CPT code other than FB removal to indicate this procedure.


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## MMAYCOCK (Mar 7, 2011)

That is exactly how the neurostimulator is implanted. I am surprised they wouldn't think that removal code was a better fit. I really appreciate you letting me know.


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## BradSW (Apr 7, 2011)

I would just go with the removal of implant code 20670/20680 , being that it is an implant not a foreign body


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