Orthopedic Coding Alert

Reader Questions:

Check Separate Incision for 20900

Question: Which codes should I use for a TKA with structural bone grafting of the lateral tibia plateau? I-m not sure I can report the graft separately because the surgeon didn't take the graft from a separate site. Pennsylvania Subscriber Answer: If the surgeon harvested the bone graft via a separate skin or fascial incision, you may report the appropriate bone graft code (20900-20902, Bone graft, any donor area -) in addition to the total knee arthroplasty (TKA), which you should report using 27447 (Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing [total knee arthroplasty]). Rule: CPT guidelines state that you may code obtaining autogenous bone or other tissue separately if the surgeon gets the graft through a separate skin or fascial incision. Exception: If the surgical code descriptor references harvesting the graft or implant, you shouldn't report obtaining the graft separately, the guidelines [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Orthopedic Coding Alert

View All

Which Codify by AAPC tool is right for you?

Call 844-334-2816 to speak with a Codify by AAPC specialist now.