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Orthopedic Coding Alert

You Be the Coder:

Multiple Screws, 1 Incision

Published on Thu Nov 06, 2003

Question: Our orthopedist extracted multiple pieces of hardware (one plate and three screws) through one incision, although two of the screws were in two different metatarsals. Can we report multiple units of 20680 for this service?

Delaware Subscriber

Answer: No. If the orthopedist removed the hardware through a single incision, you cannot report multiple units of 20680 (Removal of implant; deep [e.g., buried wire, pin, screw, metal band, nail, rod or plate]).
If your operative report states that the surgeon created two separate incisions to remove the screws from the separate metatarsals, you can report 20680 twice, with modifier -59 (Distinct procedural service) appended to the second listing.
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