Wiki Temporary Fixation

[PLAIDMAN]

My doc wants to charge for pin removal which was inserted at time of surgery as "temporary" fixation.....I told him it was included...he disagrees....we are still in global period.

It is my understanding if fixation is intended to be temporary and intended to be removed that it is included in global.

I am talking about pins that are percutaneous, & sticking out of skin.....not buried, not deep, no infections...ect..

I can only seem to find documentation in the case of hammertoe surg

Anyone direct me towards some documentation

THANKS!

 

[OCD_coder]

If the patient is a Medicare/Medicaid beneficiary or their insurance carrier follows the MCR global rules (e.g. United Healthcare) then this service is not billable and part of their Global Package definition.

For all other carriers, we bill our hardware removal(s) with a modifier 58, this is a staged/related procedure to the primary service within a global period. You cannot leave the hardware in and by CPT definition this is not part of the global package. This is advice we had received from Zupko and Associates and use with the AAOS.