to charge the 20999 the marrow must be from a separate incision
coding clinic
Bone marrow aspiration for harvesting and injecting marrow into joint
Coding Clinic for HCPCS - Second Quarter 2020 Page: 11 Effective Date: May 20, 2020
Related Information
Ask the Editor
QUESTION 11
A patient with impingement syndrome of the left shoulder presented for diagnostic arthroscopy with regenerative injection of concentrated bone marrow mesenchymal stem cells for repair. Ten cc's of bone marrow was aspirated from the iliac crest. The bone marrow aspirate was not manipulated in any way and set aside. After the diagnostic arthroscopy, 8-10cc's of the bone marrow aspirate was injected into the shoulder joint.
What is the CPT code for a bone marrow aspiration procedure in which the surgeon is harvesting the marrow via the iliac crest without biopsy or manipulation (no platelet rich plasma) and then injecting that bone marrow into the shoulder joint?
ANSWER
Assign CPT code 20999, Unlisted procedure, musculoskeletal system, general, for the harvesting of the bone marrow from the iliac crest and the injection into the shoulder joint. This is consistent with the parenthetical note in the CPT codebook under the CPT add-on code 20939, Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision (List separately in addition to code for primary procedure), which is specific to spine surgery and instructs: "For aspiration of bone marrow for the purpose of bone grafting, other than spine surgery and other therapeutic musculoskeletal applications, use 20999."
Bone graft with bone bank bone
CPT Assistant, December 2000 Page: 15 Category: Coding Consultation
Related Information
Musculoskeletal System
Question
A physician performs an open reduction and internal fixation of a fracture of an extremity. The procedure includes a bone graft with bone obtained from a bone bank. Is a separate code assigned to the grafting procedure?
AMA Comment
The bone graft codes 20900 and 20902 are separately reportable only when the graft material is an autograft and is obtained through a separate incision and not listed as part of the basic procedure. Bone bank bone is not reported using these codes.