Wiki Bone Marrow aspirate

[aekenyon87]

My provider is doing an open reduction and internal fixation of right navicular stress fracture with iliac crest bone marrow aspirate. The provider chose CPT code 20900, which I feel is incorrect. My research is steering me towards unlisted code 20999. The op report states that about 5 cc of bone marrow was aspirated from the inner table (iliac crest) and placed into the channels drilled in the navicular. Which code would be appropriate for this situation?

 

[Orthocoderpgu]

Code 20900 is used for obtaining cortical bone. Bone marrow is not the same as cortical bone. The provider has chosen the incorrect code.

 

[NRaizman]

Code 20900 is used for obtaining cortical bone. Bone marrow is not the same as cortical bone. The provider has chosen the incorrect code.

This is a common tactic by F&A orthos who use a ton of BMAC.
If you document that you extracted "spicules of bone" along with your aspirate, it qualifies for a bone graft code typically and does not get kicked out. That strategy still works for most payors.
If it is harvested, concentrated and reinjected, it would be coded like PRP: 0232T.
Otherwise it is coded 20999.