# Arch bar removal/open fracture



## hallm42

My doctor charged for a CPT #21365 and a #21462.  Then he charged for CPT #20670, arch bar removal.  Does anyone know whether we can charge for this or is included in the other charges.  

Or can anyone tell me how they bill for these services?


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## pattihc

I always bill for the arch bar removal with 20670 and modifier 58.


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## alambmichigan

I agree with pattihc, you would want to bill 20670 with the 58 modifier.  You may get denials from some payors, so you may have to do some appeal work.  Arch bar removal is not included in the surgical package of fracture repair codes.  

Amy


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## FTessaBartels

*ONE operative session?*

If the removal of the arch bar was done during the same operative session .... then that removal is probably considered incidental to the fracture repair (i.e. you had to take it out to perform the other surgery).

If you're talking about taking the patient BACK to the OR after the fracture has healed to remove the implant ... then you'd separately code the removal of implant ... either 20670 or 20680 depending on documentation. 

Hope that helps.

F Tessa Bartels, CPC, CEMC


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