Forum - Questions & Answers

Sep 1st, 2009 - djones3

You cannot separately bill for allografts...

A physician wants to bill CPT 29888 along with CPT 20926 for ACL reconstruction with allograft. These codes are not bundled according to the Correct Coding Initiative.

It is my understanding:
1) you cannot report the allograft separately because all allografts, except those used in spine surgery, are included in the surgical package

2) the graft codes in the CPT book are for obtaining autografts (the implantation of any graft is included in the surgical package for the procedure requiring the graft)

3) allografts are pre-harvested so there is no surgical work on this physician's part in obtaining the allograft so you cannot charge CPT 20926 for "obtaining" it.

Am I completely wrong? partially wrong? or totally right?

YOUR COMMENTS (YES USE CPT 20926 - or - NO DON'T USE CPT 20926 - or - USE THIS OTHER CODE _____ ) WILL BE GREATLY APPRECIATED.

Please provide references when possible.

Thanks, and have a great day!
Deb



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