DecisionHealth, DecisionHealth - 2023 Issue 11 (November)
Q&A: How to code removal of IM nail at the time of an amputation by a different surgeon
Question: How would you code the following scenario:
Dr. A, a vascular surgeon who is not in our practice, did an above knee amputation due to non-healing ankle wounds. During the same surgical encounter, our ortho surgeon, Dr. B went in and removed a femoral intramedullary (IM) nail that he had previously placed for a femur fracture. He was not the assistant at surgery and he left after removing the nail and did not participate in the amputation. The vascular surgeon did not bill with a co-surgeon modifier 62.
The problem I have is that code 20680 (Removal of implant; deep [eg, buried wire, pin, screw, metal band, nail, rod or plate]) is bundled into the amputation code. How would I code anything for my ortho surgeon?
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