Bone Allograft Coding Additions 2019

The 2019 CPT® codebook introduced three new, add-on codes to report bone allograft:

+ 20932 Allograft, includes templating, cutting, placement and internal fixation, when performed; osteoarticular, including articular surface and contiguous bone (List separately in addition to code for primary procedure)
+ 20933 … hemicortical intercalary, partial (ie, hemicylindrical) (List separately in addition to code for primary procedure)
+ 20934 … intercalary, complete (ie, cylindrical) (List separately in addition to code for primary procedure)

An allograft is tissue taken from one person for use in another person. An osteoarticular bone allograft (20932) consists of bone, articular (joint) cartilage, and other soft tissues that is used to replace large defects, such as those caused by excision of a bone tumor involving adjacent tissue, including cartilage and tendons.
Code +20932 is an add-on code that may be reported with primary tumor removal edures 23210, 23220, 24150, 25170, 27075, 27076, 27077, 27365, 27645, and 27704. The procedure includes sizing and shaping of the bone allograft, as well as placing and securing it; however, you may separate report insertion of joint prosthesis, if performed.
Do not report +20932 with 20933, 20934, 23200, 24152, 27078, 27090, 27091, 27448, 27646, 27647, and 27648.
Intercalary allograft transplantation (+20933 and +20934) also uses human tissue to reconstruct bone defect(s) after tumor resection. These allografts are positioned between joints (i.e., intercalary). Code +20933 describes partial (hemicylindrical) bone allograft, while +20934 describes complete (cylindrical) allograft.  The extent of the procedure is determined by provider documentation.
Code +20933 may be reported with primary tumor removal procedures  23210, 23220, 24150, 25170, 27075, 27076, 27077, 27365, 27645, and 27704. Do not report with 20932, 20934, 23200, 24152, 27078, 27090, 27091, 27448, 27646, 27647, or 27648.
Code+20934 may be reported with primary tumor removal procedures 23210, 23220, 24150, 25170, 27075, 27076, 27077, 27365, 27645, and 27704. Do not report with 20932, 20933, 20955, 20956, 20957, 20962, 23146, 23156, 23200, 24116, 24126, 24152, 25126, 25136, 27078, 27090, 27091, 27130, 27132, 27134, 27138, 27236, 27244, 27356, 27448, 27638, 27646, 27647, 27648, 28103, or 28107.
As with +20932, intercalary allografts +20933 and +20934 include sizing, shaping, placement, and securing of the graft.

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John Verhovshek

John Verhovshek, MA, CPC, is a contributing editor at AAPC. He has been covering medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University.

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