Neurosurgery Coding Alert
Multiple Grafts Are Allowable
Question: Can we bill separately for multiple bone grafts during a single session? For example, if the surgeon uses a morselized allograft (20930) at C3/C4 and a morselized autograft (20936) at C4/C5, are we allowed to report both codes?
California subscriber
Answer: Yes, you can report multiple bone grafts of different types during the same operative session. CPT removed the restriction on billing multiple grafts in 2000.
Therefore, you should report 20936 (Autograft for spine surgery only [includes harvesting the graft]; local [eg, ribs, spinous process, or laminar fragments] obtained from same incision) and 20930 (Allograft for spine surgery only; morselized) for the session you describe.
If, however, the surgeon used morselized allograft, for instance, at both C3/C4 and C4/C5, you would only report a single unit of 20930 because you may not report multiple units of the same bone graft code.
Keep in mind that - although proper coding dictates that you should report 20930 and/or 20936 when performed - payers may choose to bundle these procedures to any more definitive service (see "Medicare May Not Pay for Certain Bone Grafts," later in this issue).
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