# Billing for Vitagel ??



## mnk8383 (Jul 13, 2009)

Just wondering if anyone is billing cpt 86999 for Vitagel? It has been suggested that this would be the appropriate code vs. cpt 20926.


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## mitchellde (Jul 13, 2009)

No 86999 is not an appropriate code for vitagel, neiter is 20926.  I know that 20926 is the code supplied by the vendor, however this code is for *Harvesting* of fat and fasica via a separate incision.  It is not a graft application code.  I have been billing and paid quite well but I will need to see your physicians documentation first to see if the code I have been using is applicable to your scenario.


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## mnk8383 (Jul 14, 2009)

Here's the note

This procedure involved use of the Vitagel surgical hemostatic agent. This is an other tissue graft in which the patient's plasma from venous blood is taken, spun, and then combined with Vitagel (collagen and thrombin) and then applied at a separate site as the matrix sets up as a scaffold for soft tissue. This scaffold promotes soft tissue healing, improves vascularization, and stops bleeding. The application of this graft matrix to the bleeding or exposed bony surfaces and soft tissue required additional time and effort throughout the procedure. Research has shown improvements in scarring, hemoglobin levels, bleeding and postoperative healing with the use of Vitagel as an other tissue graft, and it greatly enhanced the performance and results of this procedure.


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## mitchellde (Jul 14, 2009)

I sent you a PM


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## mbort (Jul 15, 2009)

mitchellde said:


> I sent you a PM



Deb can you share your response on which code you use for Vitagel?


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## coderguy1939 (Jul 15, 2009)

Did the use of the Vitagel involve another surgical procedure?  Rebecca Woodward provided a link to Margie Vaught's website which has an excellent article on platelet rich cell injections and the use of Vitagel.  The initial post is under Platelet Rich Inj and provides the link to the article.  I suggest reading that to see how it might apply to your situation.


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## mitchellde (Jul 16, 2009)

Yes it was in conjunction with another procedure.  It will not work for every scenarior.  The physician was performing total knee replacements and using a Vital tissue graft as he called it.  After reading the op note and much searching, I came up with 27412, this was the right code as it matched perfectly his description of the procedure which was excellent and very thourough.  Now we also appended a 52 modifier since he did not harvest the chondrocyes 2 weeks prior, which is part of the 27412 procedure description.  We ran it by Medicare and BC/BS, both approved and paid very well, as do all other carriers now.  This works for knees but not for any other procedures.  This is the only doc I work with that uses vitagel and he only uses it for his total knees.  That is why I would need to see the note as any other scenarior would need to be evaluated.


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