Neurosurgery Coding Alert
Check Payer Policies for 20936 and 20930
Question: We have billed multiple claims to Medicare for spinal fusions and they are denying the use of codes 20936 and 20930. Can you give me some insight into whether there are a different set of codes to be used for demineralized bone matrix and autograft bone taken from the spinous process for arthrodesis? Codify Subscriber Answer: The codes 20930 (Allograft, morselized, or placement of osteopromotive material, for spine surgery only) and 20936 (Autograft for spine surgery only [includes harvesting the graft]; local [e.g., ribs, spinous process, or laminar fragments] obtained from same incision…) are both add-on codes for a major spinal procedure. CMS will not pay separately for these two codes because they have no associated additional physician work. They are considered to be a component of the major spinal procedure. There are also no RVUs assigned to these two codes. Your commercial carriers may pay separately for these two codes, and therefore you should still report them. You should check your payer policies to determine which commercial payers will reimburse separately for these codes.
Neurosurgery Coding Alert
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Check Payer Policies for 20936 and 20930
Question: We have billed multiple claims to Medicare for spinal fusions and they are denying the [...] - Reader Question:
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