Wiki 20936,20930

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sdunaway1

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Hello,

Has anyone received denials for the graft codes of 20930,20936 with 22551? I do not have specific payers but have been asked to research.

Thank you, for your help.
 
You would want to find out who the payers are and what the denial reason codes are. However, I would consider this basic spine coding knowledge, they are bundled. They have no fee on the fee schedule and no RVUs (CMS). Some exceptions *might* be for work comp claims. If you do a fee schedule search: Status B: Payment for covered services are always bundled into payment for other services not specified. There will be no RVUs or payment amounts for these codes and no separate payment is ever made. When these services are covered, payment for them is subsumed by the payment for the services to which they are incident

Example policy: https://www.uhcprovider.com/content...-drug/spinal-fusion-bone-healing-products.pdf
 
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