# 20931 twice



## kathydaniel (May 24, 2010)

I have a doc who is wanting to bill multiple units of 20931 because he is individually measuring and shaping the allografts for each level, not using precut grafts.  

I know that 20931 can only be billed once per session and I believe that the shaping is also included in the code.  Can anyone give me any advice on how to convince the doc that we can't bill for his personalized shaping?

Thanks!!!!


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## RebeccaWoodward* (May 24, 2010)

Could this work?

.....At the same CPT meeting, the vignette for placement of a bone allograft (code 20931) was reviewed. *This procedure described the physician work of measuring the defect size with calipers or a trial, fashioning the bone allograft for appropriate shape and size, and then examining the graft for appropriate fit after placement*. Placement of the graft was described using arthrodesis codes. Subsequent development of machined allografts created a dilemma for neurosurgeons. Although code 22851 was intended for application of prosthetic devices, it now included the example of a threaded bone dowel. However, the threaded bone dowel is "an exception" to prosthetic device usage. *In contrast, the measurement and fitting of all nonthreaded machined bone should be described using category I code 20931*.


http://www.aans.org/library/Article.aspx?ArticleId=38169


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## kathydaniel (May 26, 2010)

Thanks, I'll give a try.  I can't find anything else out there.


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