decisionhealth Newsletters, Coder Pink Sheets - 2004 Issue 5 (May)
Billing 20680 Multiple Times
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Article Overview
This article explains a coding and reimbursement question in orthopedic surgery involving removal of implanted hardware at one or more sites. It summarizes perspectives from professional organizations, Medicare-related review practices, and coding experts on when the procedure is treated as part of a larger surgery, when multiple sites may be reported separately, and when additional modifiers or medical review may be involved. The content is relevant to orthopedic coders, billing staff, and practices that handle fracture-related hardware removal.
Why This Topic Matters
Accurate reporting of hardware removal affects claim submission, modifier use, and payer review for orthopedic procedures. The topic is especially important when hardware is removed through multiple incisions or from more than one anatomic site.
Article Sections
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Hardware removal billing question
Introduces the general coding question about reporting removal of implanted hardware when more than one incision or site is involved.
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Professional organization guidance
Summarizes viewpoints attributed to orthopedic and coding organizations about reporting hardware removal and handling multiple sites.
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Medicare and bundled procedure context
Notes payer review considerations and the relationship between hardware removal and larger procedures already in global payment.
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Complicated removal and modifier use
Discusses situations described as more complex and mentions additional review or modifier-based reporting considerations.
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Expert opinions and site-based examples
Presents alternate expert interpretations and sample orthopedic scenarios involving hardware removal from separate sites.
What You Will Learn
- How the article frames the question of reporting hardware removal when there are multiple incisions.
- What general positions are described from orthopedic and coding organizations.
- How the article addresses bundled services, medical review, and complicated cases.
- What kinds of site-based scenarios are discussed by coding experts.
Who Should Read This
- Orthopedic coders
- Medical billers
- Orthopedic practice managers
- Physician coders
- Revenue cycle staff
Codes Discussed
Modifiers Discussed
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