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Orthopedic Coding Alert

Reader Questions:

20670, 20670: Multiple Screws Still Only One Code

Published on Fri Oct 08, 2010

Question: My orthopedist documented that he removed three screws through three separate incisions at the proximal tibia. The op note states that the surgeon removed the first two screws through two small stab wounds and removed the third through a small incision over the screw. How should I code this?Answer: The answer to your question will depend on the screws' purpose when the orthopedist originally placed them. If the surgeon placed the screws to hold a plate in place, you should report 20680 (Removal of implant; deep [e.g., buried wire, pin, screw, metal band, nail, rod or plate]) to cover removing all the screws. Because the orthopedist placed the plate and screws as a single internal fixation device to treat one fracture, the single code represents the removal.But if the surgeon placed the individual screws without a plate to stabilize a fracture, you would report their removal as 20680 for [...]
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