20680 or 26320 in the office

HPI Comment: patient comes in today for pin removal of his LEFT long finger. The dorsal pin has been removed. Patient has no idea how it came out. The distal pin is palpable under the skin. I discussed the risks, benefits, alternatives of bedside removal of the pin under local anesthesia versus continuing with formal OR removal. He would like to try bedside removal to save some money and time. I think this is very reasonable. DATE OF SURGERY: 6/7/17 SURGERY: I&D, ORIF left long finger open bony mallet fracture 72 year old LHD male new patient 1st post op left long finger. Patient reports his pain is controlled. He denies fevers or chills. He denies any wound issues. No other complaints. Interval HX 7/19/17: Patient returns today for 2nd post op left long finger.

26320 REMOVAL OF IMPLANT FROM HAND ( Procedure note:Patient informed of the risks, benefits, alternatives of pin removal from the LEFT long finger. He opts to proceed. Post sterile prepping and draping of the LEFT hand, 1% lidocaine plain was infiltrated to the fingertip. a small stab incision was made over the distal phalangeal tip of the LEFT long finger. The pin was removed without difficulty with pliers. The wound was irrigated. A Steri-Strip was applied. Patient tolerated the procedure well.)

Our physician wants to charge the 26320 in the office on a Medicare patient but I believe this is not the appropriate code as medicare denied it for pos.  Which is the correct code to bill?


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