APMA News - March/April 2021 - 20

Continued from page 18

GP: 090 | Assist: | NF RVU: 17.68 | FAC RVU: 12.17 |
Work RVU: 5.96 | MUE: 3 | CCI Edits | CPT to ICD9 | CPT
to ICD10
CPT code 20680 has an MUE of 3, so the maximum number of units you can bill this code for this surgery is three. In
this example, we are submitting code CPT 20680, and CPT
20680-59: one time for the removal of the deep hardware for
the tibia, and the other time for the hardware removal from
the fibula. (Note: Hardware removal is coded per fracture site
or area of injury [not per screw/plate]. You must list the location of the screws on your operative report [CPT Assistant
June 2009, Vol. 19, Issue 6.])
Adding on to this example: For the same surgery, if you
would like to add removal of hardware from a previous Lapidus surgery because you believe the hardware is now causing

the patient pain, you would submit CPT 20680 three times:
20680, 20680-59, and 20680-59.
Let's say in addition to the bi-malleolar and post-Lapidus
hardware removal, you decide to remove hardware from another site on the same day, perhaps hardware from an old fifth
metatarsal ORIF surgery. You try to submit code 20680 four
times, but the code has an MUE of 3. What happens? Do you
get paid for three units and get rejected on the fourth? In this
example, the insurance company will actually deny your whole
claim and won't pay you anything until your claim is fixed.
So, as you can see from that example, understanding how
NCCI, MUE, and MAI have an impact on your billing is critically important to your reimbursement. Take the time to get
it right in your original claim and provide appropriate documentation to help avoid the hassle of denials and appeals. n

Be an Advocate for
Podiatry During the
Virtual Legislative
Conference

he 2021 Legislative Conference is going virtual! Register now to advocate for podiatric medicine and surgery
on Wednesday, May 12, from 9 a.m.-5 p.m. EDT, from
the comfort of your own home or office. Learn more at
www.apma.org/legconf.
Traditionally, the Legislative Conference has taken place
immediately following the APMA House of Delegates in
Washington, DC. Members have spent the day on Capitol
Hill talking with their representatives and senators about
important issues facing the profession, including patient
access and physician parity. This year's virtual event will
allow more members than ever to participate in the only
organized effort to shape federal policies that affect podiatrists' ability to practice.
During the event, you will have one or more virtual meetings with your elected officials. The meetings will be set up
for you, and you will receive talking points and background
materials beforehand so you are informed and prepared.
These conversations are your opportunity to introduce yourself and share more about the role podiatrists play in keeping
America healthy and active. A chief goal of the event is to
garner cosponsors for the Helping Ensure Life- and Limb-Sav-

20 APMA News March/April 2021

ing Access to Podiatric Physicians (HELLPP) Act and to push
for passage of the bill this summer. You will also address ongoing efforts for economic relief from the impacts of the public health emergency, as well as other key issues. The profession has seen significant victories in the last few years and has
the opportunity to make a big impact with a new Congress
and administration.
While APMA advocates year-round for podiatry, elected officials want to hear directly from their own constituents. Your
voice as a voter carries tremendous weight, and developing
personal relationships with your representative and senators
can pay dividends for years to come. For young physicians
and podiatric medical students, the virtual nature of this
year's event presents a unique opportunity to participate and
begin to form those vital relationships.
If you register to participate in the Legislative Conference,
be sure to block out your full day (9 a.m.-5 p.m. EDT) on
May 12. Specific appointment times will be shared in late
April. If you have any questions, contact APMA Director of
Legislative Advocacy Benjamin J. Wallner at bjwallner@
apma.org. To complete your registration, visit www.apma.
org/legconf. n

http://www.apma.org/2021legislativeconference http://www.apma.org/legconf http://www.apma.org/legconf

APMA News - March/April 2021

Table of Contents for the Digital Edition of APMA News - March/April 2021