Oral Surgery Coding & Reimbursement Alert

Question: Is it appropriate for 20680 to be used in an office setting? I feel that it is possible to perform 20670 in the office setting but for 20680, it needs to be done only at the hospital. Is this correct?

Michigan Subscriber

Answer: Both 20670 (Removal of implant; superficial [e.g., buried wire, pin or rod][separate procedure]) and 20680 (...deep [e.g., buried wire, pin, screw, metal band, nail, rod, or plate]) are CPT® codes that you will use for implant removals. You will use 20670 when the implant removal involves a superficial wound that has a simple closure requiring sutures or Steri–strips. You will resort to using the CPT® code 20680, when implant removal involves going down through the muscle layers and into the bone that requires a more complex, layered closure.

Since work involved in 20680 includes going into the deeper layers and complex closure, you might be assuming that this procedure can only be done in a hospital setting. However, as many practices have operating or procedure rooms, they are able to perform 20680 in an office setting.

Bottom line: Base the code on the type of closure the physician performs, not on the place where the service is provided.