Reminder: Reporting insertion and removal of bone fixation devices

Insertion of fixation devices
Use procedure code *20650 for skeletal traction or for the percutaneous fixation of a fracture or dislocation. Bill either closed reduction or percutaneous fixation — not both.

Removal of fixation devices
Reimbursement for removing the external bone fixation devices is included in the reimbursement for the original surgical procedure in which the devices were inserted. Procedures would not be billed separately from the initial surgical procedure.

However, you may bill procedure code *20670 as a separate code if you’re not an associate of or a member of the same group as the original operating physician.

Superficial pin removal refers to K-wires, or to buried wire or rods within the skin layer that may be removed with or without local anesthesia, but don't require incision or dissection of muscle, tendon or fascia. Pins located distal to the metacarpal or metatarsal joints are all considered superficial pin removal whether or not the pins are located below the dermis.

Deep pin removal refers to removal of a wire, pin, screw, metal band, nail, rod or plate that’s buried so that the ends or surface are located beneath the dermal layer.

Note: Do not use procedure code *20680 to report the removal of temporary K-wires.

None of the information included in this article is intended to be legal advice and, as such, it remains the provider’s responsibility to ensure that all coding and documentation are done in accordance with applicable state and federal laws and regulations.