Podiatry Coding & Billing Alert

Question: When would I report 20670 or 20680 for an implant removal? What is the difference between these two codes?

Tennessee Subscriber

Answer: Both 20670 (Removal of implant; superficial (eg, buried wire, pin or rod) (separate procedure)) and 20680 (Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)) are implant removal codes. You should report 20670 for a superficial wound that has a simple closure requiring sutures or adhesive strips. On the other hand, code 20680 typically involves going down through layers of muscle and into the bone. This type of closure requires a more complex, layered technique.

If a patient has a skeletal deformity or an injury like a fracture, then your podiatrist may use skeletal fixation devices such as pins, rods, or wires to join skeletal parts and maintain their normal alignment as healing takes place. After the injury has healed, your podiatrist will remove the implant and close up the area. One common scenario is to use a K-wire on metatarsals or tendons in the toes to keep everything aligned during the healing process.

In some cases, you may be able to bill both codes on one claim. For example, K-wire removal may be separately billable if you’re seeing a patient who had a previous surgery in which K-wire was inserted, but removal was unsuccessful. If you need to remove previously placed K-wire to restabilize a patient, you can report 20680, according to the September 2012 edition of CPT® Assistant. And you’ll bill superficial pin or K-wire removals not requiring a layered closure with 20670.