Wiki Hardware removal for previous suture anchor

[nmendez1]

Hi there. My physicians have been pushing for me to bill hardware removal of previous suture anchors. The suture anchors are from previous repairs in either the shoulder or the knee. I have always been told that this falls under the debridement and is not separately payable for arthroscopic procedures. It is also my understanding that the 20680 is for open procedures only. I have researched this over and over and I have seen some suggest to go ahead and bill the 20680, I have seen some suggest to bill the unlisted 29999 and compare it to the 20680, I have seen some suggest to bill it with the removal of foreign body, and I have seen some state this falls under debridement which is usually included. These are being billed with other arthroscopic procedures as well. I have not been able to find a definitive answer or an article from the AMA or the AAOS that would support any of these answers. Does anyone have any suggestions? Is there an article that you can point me to? Any help would be appreciated. Thank you

 

[cpaisley05@gmail.com]

How was this done? If open, then 20680 is appropriate IF removed from bone/deep hardware.
If via scope, then it could be FB removal or debridement depending on if other areas were debride as well.

 

[nmendez1]

My problem is when it is done arthroscopic. For instance, patient had a meniscus repair. Now they are coming back in for a new tear say a year later. The physician goes to do an arthroscopic meniscectomy and while doing that procedure a suture anchor from the previous repair is found to be loose so it is removed. I think this would be included, but the physician feels this should be a separate procedure.

 

[RyanRaichCPC]

I agree with the above, this would be included. He has to remove the previous anchor in order to do the meniscectomy anyways.

 

[Orthocoderpgu]

The knee has three compartments. Only one arthroscopic procedure may be reported per compartment. And I agree with the above, if it was necessary to remove the suture to debride the meniscus, it is included. So there are at least two ways to exclude this procedure. Keep in mind your surgeon does see it differently. They are taught that there is a CPT code for every procedure they do (basically speaking) and so it's easy for them to just add up all the CPT codes after a surgical session. Just because it's performed, does not mean that it can be billed.

 

[nmendez1]

Thank you everyone for your help. This helps when I talk to the physicians about this.