Reader Questions:
Screw Insertion May Fall Under Unlisted
Published on Mon Jan 23, 2006
Question: Our surgeon performed an intramedullary implant with screws (27759) in July last year, and in November he had to remove and replace distal locking screws. To code the November procedure, should we report 20680 and 27756 with appropriate modifiers?
Arizona Subscriber
Answer: No. Because the global period of the previous surgery had already expired, you shouldn't append modifiers to the second procedure. In addition, neither 20680 (Removal of implant; deep [e.g., buried wire, pin, screw, metal band, nail, rod or plate]) nor 27756 (Percutaneous skeletal fixation of tibial shaft fracture [with or without fibular fracture] [e.g., pins or screws]) properly describes the service.
Instead, you should report the unlisted-procedure code 27899 (Unlisted procedure, leg or ankle).
