How To Use CPT Code 20680

CPT 20680 describes the removal of deep implants, such as buried wires, pins, screws, metal bands, nails, rods, or plates. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 20680?

CPT 20680 is used to describe the removal of deep implants, such as buried wires, pins, screws, metal bands, nails, rods, or plates. This code is used when a healthcare provider reopens the original incision, extends it to access the deep bone implant, and removes it from the surrounding tissue. The procedure typically involves going down through muscle layers and into the bone, requiring a more complex, layered closure.

2. Official Description

The official description of CPT code 20680 is: ‘Removal of implant deep (e.g., buried wire, pin, screw, metal band, nail, rod or plate).’ There are no additional notes or modifiers specified for this code.

3. Procedure

When performing CPT 20680, the healthcare provider follows these steps:

1. The patient is appropriately prepped and anesthetized.
2. The provider reopens the original incision.
3. The incision is extended by dissecting through fascia and muscle layers to access the deep bone implant.
4. The provider identifies the deeply inserted implant and unscrews it, dissecting it from surrounding tissue if necessary.
5. The deep implant is extracted by pulling it out with sharp forceps.
6. The wound is closed with layered sutures.

4. Qualifying circumstances

CPT 20680 is used when there is a need to remove deep implants, such as buried wires, pins, screws, metal bands, nails, rods, or plates. This procedure is typically performed after the defect or injury has healed, and the implant is no longer needed. The patient must have a documented medical necessity for the removal of the implant, and the procedure must involve going down through muscle layers and into the bone.

5. When to use CPT code 20680

CPT code 20680 should be used when a healthcare provider performs the removal of a deep implant, such as a buried wire, pin, screw, metal band, nail, rod, or plate. This code is appropriate when the procedure involves going down through muscle layers and into the bone. It should not be used for superficial wound closure requiring sutures or adhesive strips, which would be reported with a different code (e.g., CPT 20670).

6. Documentation requirements

To support a claim for CPT 20680, the healthcare provider must document the following information:

• Reason for the removal of the deep implant
• Type of deep implant being removed
• Date of the procedure
• Details of the procedure, including the incision site and closure method
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 20680, ensure that the procedure involves the removal of a deep implant, such as a buried wire, pin, screw, metal band, nail, rod, or plate. Use the appropriate CPT code based on the complexity of the closure performed by the provider. It is important to note that CPT 20680 should not be reported with other codes for removal and reinsertion of specific implants, such as sinus tarsi implants (use 0510T for removal and 0511T for removal and reinsertion).

8. Historical information

CPT 20680 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 20680

There are no similar codes to CPT 20680 within the musculoskeletal system range.

9. Examples

1. A provider performs the removal of a deep screw from a patient’s femur.
2. A surgeon removes a buried wire from a patient’s hand.
3. An orthopedic specialist extracts a metal plate from a patient’s forearm.
4. A healthcare provider removes a deep pin from a patient’s tibia.
5. A surgeon unscrews and removes a deep rod from a patient’s spine.
6. An orthopedic specialist extracts a metal band from a patient’s ankle.
7. A provider removes a buried nail from a patient’s foot.
8. A surgeon unscrews and removes a deep screw from a patient’s shoulder.
9. An orthopedic specialist extracts a metal plate from a patient’s clavicle.
10. A healthcare provider removes a deep wire from a patient’s hip.