Wiki Hardware removal within global

[jodyrichardson]

Is it appropriate to bill for 20670 done in the office in the global period? I've been trying to locate documentation from CMS or AAOS to support this and can't find anything. The hardware removal was done from a finger and there were no complications. I have a hard time believing this is billable but need solid documentation to share with the provider to support this. Or am I wrong? Does anyone have any documentation to support billing this or not billing this in the global period?

Thank you!

 

[mbcool]

You clearly say, "in the office" then no it is not billable. CMS and CPT clearly show that if you return to the operating room or procedure room then it is billable. If the provider takes them to a seperate, designated procedure room, anesthesized the area, incised to remove the hardware (even superficially) then the modifier to use would be 58 staged or related procedure. The 58 modifier starts a new global period and 20670 has 10 days. Don't use 20670 if the provider is just pulling out the pin(s) because that is not a seperately billable service. 20670 includes an incision and closure. See the MLN Global Surgery Fact Sheet ICN907166 Aug 2013 and the CPT Lay Descriptions for more information.