General Surgery Coding Alert
Clarify Coding for Drug Delivery Device
Question: Our surgery practice has access to a 3-D printer which we use to create biodegradable implants for drug delivery. We’ve been told that the code for inserting these implants limits it to non-biodegradable materials. How should we code this? Mississippi Subscriber Answer: The correct code is 11981 (Insertion, drug-delivery implant (ie, bioresorbable, biodegradable, non-biodegradable)). Although the code descriptor includes “biodegradable,” that wasn’t always the case. Prior to January 2022, the descriptor was Insertion, non-biodegradable drug delivery implant. That may be the reason you heard that the code was limited to nonbiodegradable materials. Caveat: If the surgeon inserts the drug delivery device below the fascia or within the bone marrow, you should use a different code. For instance, you might use +20700 (Manual preparation and insertion of drug-delivery device(s), deep (eg, subfascial) (List separately in addition to code for primary procedure)) or +20702 (Manual preparation and insertion of drug-delivery device(s), intramedullary (List separately in addition to code for primary procedure)), depending on the surgeon’s documentation. Notice that the preceding two codes are add-on codes. You should use one of those codes only in addition to the parent code. CPT® provides a list of appropriate codes that you may pair with +20700 or +20702.
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