Removal of IMF Wires and Arch Bars

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June 26, 2014

Question:

Thank you, Kim, for coming to our practice recently. We really learned a lot from you! I forgot to ask this question. I do not usually bill for the removal of the IMF wires and arch bars postop in the office since I have always been told it is included in the original surgical code 21453. However, my colleagues have been advising me to use 20670 (w/ or w/o -58) for this removal. So, before I start following their coding advice, I thought I should check with you.

Answer:

Thank you so much for your kind words! We had a great session – it was enjoyable. You are correct to not bill for removal of the IMF wires and arch bars postop when done in your office. This activity is included in the global package for 21453; if you put on the IMF wires/arch bars you are expected to take them off. That said, if you took the patient back to the OR, then you could bill 20670 (you will append modifier 58 since it was planned or anticipated that you’d remove the arch bars during the global period). However, removal in the office is included in your payment for the initial surgical procedure.