# Bone supplement HCPCS code needed



## martnel (Nov 18, 2009)

For the screws, for Cigna, we use C1713, and that got pd, but for the bone supplement and guidewires (see below), they denied - we did send in invoices/implant records/opreport, using L8699 for all these years, this is the first time this is denied:

~*The ETX BSM/gamma calcium phosphate supplement *was then prepared.  Using approximately 4 cc of the 5 cc prepared, it was placed in the elevated portion of the lateral tibial plateau.  After reaming over the guidewires, two 4.5 mm screws were then placed.  ~

Does anybody have another code we can use?  These Insurance companies keep on changing the rules on a daily basis, it's hard to keep up!  LOL!


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## rgonzalez16 (Nov 18, 2009)

What CPT code do you use for reaming?


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## martnel (Nov 19, 2009)

The procedure was a 29855, which includes the reaming.  I don't know that there is a seperate code for reaming.


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## martnel (Nov 23, 2009)

For in case anybody else needs this, here is the response from the Etex rep:


October 5, 2009
Coding is at the discretion of the provider. Coding information is provided here
solely as a reference.
A facility, whether inpatient/outpatient or hospital/surgery center, may choose to
code ETEX materials as the currently do for other bone graft materials.
There is not a specific CPT of HCPCS code for the implantation of ETEX
products, but each facility may have a pass through, revenue or carve out code depending on the insurance.
One code that may be relevant in an outpatient setting is a HCPCS Code, C1713.  Anchor for opposing bone-to-bone or soft tissue-to-bone. This category now also applies to synthetic bone substitutes that may be used to fill bony voids or gaps (ie, bone substitute implanted into a bony defect created from trauma or surgery).
http://www.findacode.com/hcpcs/c1713-anchorscrew-opposing-bonetobone-softtissuetobone-
implantable-hcpcs-code.html
For the inpatient setting, one code that may be relevant is:
ICD-9 84.55, Insertion of bone void filler
Insertion of:
acrylic cement (PMMA)
bone void cement
calcium based bone void filler
polymethylmethacrylate (PMMA)
Excludes:
that with kyphoplasty (81.66)
that with vertebroplasty (81.65)


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## mmorningstarcpc (Nov 30, 2009)

I have tried to open the link supplied above and cannot access it as I do not have a login for that site.  Can you please provide what resource the link references as to what is included now in this code?  I have looked at all of my resources and see nothing that includes bone substitutes, such as Etex.

Thanks for your help!


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## tlucarelli (Apr 1, 2019)

*C1713 for bone graft substitutes*

This was surprising to me but I found this article which clearly states on page 5 that C1713 can be used for bone graft substitutes:

https://www.cms.gov/Medicare/Medica...atientPPS/downloads/DeviceCats_OPPSUpdate.pdf


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## ornina@imsillinois.com (Apr 8, 2020)

C9359 is Bone void Filler


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