Orthopedic Coding Alert

Question: One of my surgeons is billing out an in-office pin removal during the post-op period (20670-58). He is getting paid for these, but is this correct coding?

California Subscriber

Answer: Because the patient presented to your office, rather than the operating room, for the pin removal, you should not collect separate reimbursement for the pin removal. It is most likely covered under the 90-day global period for the procedure.

In addition, the pin removal is a standard part of fixation procedures, and payment for the removal is already included in reimbursement for the procedure.

If your surgeon (or another surgeon in the same practice) placed the pins, you cannot collect separate payment for your surgeon’s work removing them -- unless he removed them in the operating room under anesthesia, in which case you would append modifier 58 (Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period) to 20670 (Removal of implant; superficial [e.g., buried wire, pin, or rod] [separate procedure]).

You cannot charge for the service you describe, but you should code it using 99024 (Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason[s] related to the original procedure) for recordkeeping purposes.