Wiki 20670, multiple units

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daws235@lni.wa.gov

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I attempt to resolve billing disputes that providers have with private workers' compensation payers. I need some help with this one and hope someone can assist. I've googled and used CPT Assistant, but can't find anything definitive.


The operative report states the patient is postoperative from open trmt of a fifth metacarpal fracture. Two "Kirschner wires used for fixation of the metacarpal base fracture . . were removed without complication".

The provider is billing two line items for this service: 20670, and 20670-59. Are both lines/wire removals
payable, or does the close proximity of the wires disallow payment of the 20670-59?
 
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20670

This is what the NCCI manual says, "The code descriptors for CPT codes 20670 (removal of implant; superficial...) and 20680 (removal of implant; deep...) do not define the unit of service. NCCI policy allows one unit of service for all implants removed from an anatomic site. This single unit of service includes the removal of all screws, rods, plates, wires, etc. from an anatomic site whether through one or more surgical incisions. An additional unit of service may be reported only if implant(s) are removed from a distinct and separate anatomic site."

I don't have your complete operative notes, but with what you stated, I would only bill one line with one unit of service.
 
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