IMPLANT vs. FOREIGN BODY

What are the new rules that went into effect on January 1, 2022 for the removal of hardware? I am not sure whether to bill for the removal of an implant or for the removal of a foreign body. How do you distinguish between an implant and a foreign body?

2022 Coding Change/Update: Implant vs. Foreign Body

It is important to access the 2022 CPT Manual. Under Surgery Guidelines, you need to access the “Foreign Body/Implant Definition.”

Foreign Body/Implant Definition:

• • “An object intentionally placed by a physician of other qualified health care professional for any purpose (eg. diagnostic or therapeutic) is considered an implant. An object that is unintentionally placed (eg. trauma or ingestion) is considered a foreign body. If an implant (or part thereof) has moved from its original position or is structurally broken and no longer serves its intended purpose or presents a hazard to the patient, it qualifies as a foreign body for coding purposes, unless CPT coding instructions direct otherwise or a specific CPT code exists to describe the removal of that broken/moved implant.”

If an Implant Needs to be Removed (ie. Internal Fixation):

• • 20680 Removal of implant; deep (e.g., buried wire, pin, screw, metal band, nail, rod or plate)

If Foreign Body is Removed:

• • 28190 Removal of foreign body, foot; subcutaneous
• • 28192 Removal of foreign body, foot; deep
• • 28193 Removal of foreign body, foot; complicated

This is my opinion.

Michael G. Warshaw

DPM, CPC

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