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Anesthesia Coding Alert

Reader Question:

21127 Versus 21215

Published on Fri Jun 01, 2001

Question: What is the difference between codes CPT 21127 and 21215?

New Mexico Subscriber

Answer: These codes include the harvest of bone, but are slightly different. Code 21127 (augmentation, mandibular body or angle; with bone graft, onlay or interpositional [includes obtaining autograft]) states that augmentation is in two areas the mandibular body or angle. Code 21215 (graft, bone; mandible) does not state augmentation or limit it to those two areas. Also, 21127 carries 19.62 RVUs compared to 21215s 17.97, so reimbursement varies depending on which code is appropriate. Anesthesia would be billed with ASA codes 00190 or 00192. The anesthesiologists decide whether the procedure was radical or not. Many practices use radical codes when cases exceed certain time limits (an individual decision), and some set hours or 16 units as the limit and make the diagnosis the determining factor.
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