Wiki bone allograft

[plasticscoder]

when performing an ORIF of metacarpal fracture with the use of bone allograft, is the bone allograft separately reportable and if so, what code should be billed?

 

[TonyaMichelle]

Bone Graft

I would use Codes:

26615 (Open tx of metacarpal fracture, single, includes internal fixation, when performed, each bone)

20900 (Bone graft, any donor area, minor or small)

Hope this helps..

 

[plasticscoder]

Thanks for replying Tonya. I reviewed CPT 20900 but thought not to bill because it states 'autogenous' bone graft/harvest. The bone utilized for the case in question is an allograft.

 

[plasticscoder]

located this answer from CPT Assistant...

Coding Consultation

Musculoskeletal System, Surgery, 20900, 20902 (Q&A)

Question

A physician performs an open reduction and internal fixation of a fracture of an extremity. The procedure includes a bone graft with bone obtained from a bone bank. Is a separate code assigned to the grafting procedure?

AMA Comment

The bone graft codes 20900 and 20902 are separately reportable only when the graft material is an autograft and is obtained through a separate incision and not listed as part of the basic procedure. Bone bank bone is not reported using these codes.

 

[dclark7]

The bone allograft is supplied by the facility so the physician cannot bill for it. It's paid for under the resources used by the facility.

 

[TonyaMichelle]

Thanks for bring that to my attention PLASTICSCPT, I only went by the Cpt book and it does not address what type of bone donor, it only said, any donor, so after I read your message, I went on my Ingenix program and looked at the Lay terminology definition and saw Autograft. That's what I get for going by Cpt book only.