Anesthesia Coding Alert

READER QUESTIONS:

Consider Options for Pectus Bar Removal

Question: Which surgical and anesthesia codes apply to pectus bar removal?


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Answer: The correct surgical code is CPT 20680 (Removal of implant; deep [e.g., buried wire, pin, screw, metal band, nail, rod or plate]). This crosses to many anesthesia codes, depending on the situation, but none of the codes specifies pectus bar removal. Because of this, some coders recommend reporting 00474 (Anesthesia for partial rib resection; radical procedures [e.g., pectus excavatum]) with modifier -52 (Reduced services). 

This is the same code you report for the original procedure with 13 base units plus time. Because the removal is less intensive than the rod placement, reduce the base units because the procedure is not as invasive as the bar placement and include a note in the Remarks box that the claim is for pectus bar removal.

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