Wiki Removal of hardware LT Calcaneus, 1st metatarsal, 2nd metatrsal

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carol52

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Hello,
I have a patient coming back for removal of hardware from a previously healed fracture of the
Calcaneus, the 1st metatarsal and the 2nd metatarsal..
Bone surface was curetted and thoroughly irrigated.
these were all separate incisions can I code the 20680 x's 3
Thanks,
Carol
 
From NCCI Policy Manual 01/01/2024 IV-14:
"3. The code descriptors for CPT codes 20670 (Removal of implant; superficial...) and 20680(Removal of implant; deep...) do not define the unit of service. The Centers for Medicare& Medicaid Services (CMS) allows one unit of service for all implants removed from ananatomic 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 distinctand separate anatomic site."
I suspect all of these would be considered part of the foot, so all from the same anatomic site. But that's just my take. I've never had a payer pay for more than one unit, even when hardware was removed from contralateral sides of the body.
Anyone else care to weigh in?
 
I would probably do two in this case. One for the MTs and one for the calcaneus. While they are all in the "foot" the calcaneus is separate from the MTs. Two different fractures. I would also ask what was removed from the MTs, screw, pin, plate...? Could be 20670 depending.
 
I think this sound like a good way to bill this out... I agree that the Calcaneus is separate and the other 2 are metatarsals of the same area...
Thanks for your response.
Carol
 
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