AMA CPT® Assistant - 2009 Issue 6 (June)
Removal of Orthopedic Fixation (Codes 20670 and 20680) (June 2009)
June 2009 pages 7-9 Coding Clarification: Removal of Orthopedic Fixation (Codes 20670 and 20680 ) All forms of treating bone fracture(s) follow one basic rule: the fragments must be reapproximated and immobilized in proper position until they are healed, with new bone being formed around the edges of the broken fragment(s). The specific method of treatment depends on: the severity of the break; whether it is "open" or "closed;" and the specific bone involved—that is, a broken bone in the spine (vertebra) is treated differently from a broken leg bone or a broken rib. Orthopedic fixation devices...
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Article Overview
This CPT Assistant article explains coding considerations for orthopedic fixation removal and related external fixation services. It is aimed at medical coders, billing staff, and orthopedic practices that need to understand how the article frames hardware removal scenarios, related procedures, and the reporting of multiple services in the same session. The discussion includes broad guidance, examples, and references tied to fracture fixation and implant removal.
Why This Topic Matters
Orthopedic hardware removal can involve multiple implant types, sites, and procedural contexts, so understanding the article helps identify when related CPT services are being discussed and how the premium guidance is organized.
Article Sections
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June 2009 pages 7-9
Publication and source context for the coding clarification article.
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Coding Clarification: Removal of Orthopedic Fixation (Codes 20670 and 20680)
Overview of orthopedic fixation removal and the surrounding clinical and procedural context discussed in the article.
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Removal of Hardware
General discussion of fixation removal, external fixation systems, and related CPT reporting considerations.
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Uniplane ExternalFixation System
Section focused on external fixation system context and how removal is addressed in relation to the broader fixation discussion.
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Examples of Use of Codes 20670 and 20680
Illustrative scenarios used to compare different fixation removal situations across several anatomic sites and implant configurations.
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Removal of Deep or Superficial Bimalleolar Plate and Screws
Example section addressing ankle fixation removal scenarios involving different implant locations and levels of removal.
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Removal of Plate and IM Nail and Interlocking Screws—Proximal Tibial Plateau and Tibial Shaft Fractures (Noncontiguous Fractures)
Example section covering hardware removal from separate fracture sites in the tibia during the same surgical session.
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Removal of Separate Plate/Screw Systems—Both Bone Forearm Fracture
Example section addressing hardware removal from separate bones in a forearm fracture context.
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References
Source citations supporting the coding clarification article.
What You Will Learn
- How the article frames orthopedic fixation removal in relation to fracture care
- How the article distinguishes broader external fixation topics from implant removal topics
- What kinds of example scenarios are used to illustrate reporting considerations
- Which professional sources are cited in support of the guidance
Who Should Read This
- Medical coders
- Billing and reimbursement staff
- Orthopedic practices
- Compliance and coding educators
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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