Orthopedic Coding Alert

Question: During post-op surgery for insertion of pins in finger, can we charge for removal of pins in office as a staged procedure with a -58 modifier if the physicians documentation testifies to that upcoming procedure?

Kittie Yates
Carbondale, Ill.

Answer: Pin removal can be charged only if it is performed beyond the global surgical period, which is usually 90 days for major surgical procedures, i.e., ORIF PIP joint. Therefore, if the pins are removed within the global surgical period (0-90 days) you cannot charge. This procedure would be considered bundled into the original surgical procedure, i.e., ORIF PIP joint. If the pin removal is performed after the global surgical period (0-90 days), then you can charge for the pin removal. Since it is outside of the global surgical period, no modifier is needed.