Wiki Replacement of hardware 20680??

[holsonf]

For a femur fracture a lag screw was exchanged and the set screws were tightened. The doctor coded it as a 20680 removal of implant; deep. However, no hardware was removed it was just replaced & tightened. Any suggestions on how this should be coded would be greatly appreciated!
Thank you

 

[Orthocoderpgu]

20680 is the best so far

code 20680 is probably the closest code your going to find as the physician did replace hardware.

Dr. Pachaeck has answered this question in this forum previously, but without a very detailed note stating pathology it would be hard to indicate any other coding with just this information.

 

[AlanPechacek]

I remember responding to a query about this issue in the past, but I can't remember when that was nor what I said exactly at that time. For what it amounts to, the patient in question sustained a femoral fracture of some type that was treated with ORIF, apparently with plate and screws. I am not certain why the Lag Screw had to be replaced, but in addition to that some of the screws in place had to be tightened as well. So, in essence this was a limited "Revision" of the original ORIF, which of course doesn't have a code. I don't think 20680 does this case justice as to the work done. My "current" thinking would be to use the original ORIF code with Modifier 52: Reduced Services.

Maybe this will help.

Respectfully submitted, Alan Pechacek, M.D.