How To Use CPT Code 20250

CPT code 20250 describes the procedure of open biopsy of the vertebral body of the thoracic spine. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 20250?

CPT 20250 is a code used to describe the open biopsy procedure of the vertebral body in the thoracic spine. This procedure involves obtaining tissue samples from the vertebra for diagnostic study of suspected disease conditions, such as malignancy or infection, like osteomyelitis.

2. Official Description

The official description of CPT code 20250 is: ‘Biopsy, vertebral body, open thoracic.’

3. Procedure

The open biopsy of the vertebral body in the thoracic spine is performed when the provider needs to obtain tissue samples from deep within the vertebra for diagnostic purposes. The patient is appropriately prepped and anesthetized and placed in a prone position. The provider makes an incision in the skin over the suspected lesion site in the thoracic spine. They carefully access the tumor or abnormal tissue of the vertebral body by parting the soft tissue and muscle layers. Radiological studies may be referred to aid in locating the lesion. Using a precision cutting tool, the provider obtains a small sample of the diseased tissue from the vertebra. They then reposition the soft tissues and muscles and close the surgical incision with layered sutures.

4. Qualifying circumstances

CPT code 20250 is used when there is a need to perform an open biopsy of the vertebral body in the thoracic spine. This procedure is typically done to obtain tissue samples for diagnostic study of suspected disease conditions, such as malignancy or infection like osteomyelitis. The patient must have a suspected lesion in the thoracic spine, and the biopsy must be performed by a qualified healthcare professional.

5. When to use CPT code 20250

CPT code 20250 should be used when an open biopsy of the vertebral body in the thoracic spine is performed. This code is appropriate when the provider needs to obtain tissue samples from deep within the vertebra for diagnostic purposes. It is important to note that CPT code 20250 should not be used for superficial biopsies or biopsies performed on other areas of the body.

6. Documentation requirements

To support a claim for CPT code 20250, the healthcare professional must document the following information:

• Patient’s diagnosis and the need for an open biopsy of the vertebral body
• Location of the suspected lesion in the thoracic spine
• Date of the procedure
• Details of the procedure, including the incision, access to the tumor or abnormal tissue, and obtaining the tissue sample
• Repositioning of soft tissues and muscles
• Closure of the surgical incision with layered sutures

7. Billing guidelines

When billing for CPT code 20250, ensure that the procedure performed is an open biopsy of the vertebral body in the thoracic spine. It is important to follow the documentation requirements and provide accurate and detailed information to support the claim. CPT code 20250 should not be reported with other codes unless there are additional procedures performed during the same session that are separately reportable.

8. Historical information

CPT code 20250 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 20250

There are several similar codes to CPT code 20250 that describe different biopsy procedures on the musculoskeletal system. Some examples include:

• CPT 20205: Biopsy, vertebral body, open, thoracic
• CPT 20200: Biopsy, muscle, superficial
• CPT 20206: Biopsy, vertebral body, open, lumbar
• CPT 20225: Biopsy, soft tissue; deep
• CPT 20240: Biopsy, bone, excisional

9. Examples

1. A patient with suspected vertebral malignancy undergoes an open biopsy of the vertebral body in the thoracic spine to obtain tissue samples for diagnostic study.
2. An individual with suspected osteomyelitis in the thoracic spine undergoes an open biopsy of the vertebral body to confirm the presence of infection.
3. A healthcare professional performs an open biopsy of the vertebral body in the thoracic spine on a patient with a suspected lesion to determine the nature of the abnormal tissue.
4. A provider performs an open biopsy of the vertebral body in the thoracic spine on a patient with a suspected malignancy to obtain tissue samples for further analysis.
5. An individual with a suspected infection in the thoracic spine undergoes an open biopsy of the vertebral body to confirm the presence of osteomyelitis.
6. A healthcare professional performs an open biopsy of the vertebral body in the thoracic spine on a patient with a suspected lesion to rule out malignancy.
7. A provider performs an open biopsy of the vertebral body in the thoracic spine on a patient with a suspected infection to obtain tissue samples for microbiological analysis.
8. An individual with a suspected malignancy in the thoracic spine undergoes an open biopsy of the vertebral body to confirm the presence of cancerous tissue.
9. A healthcare professional performs an open biopsy of the vertebral body in the thoracic spine on a patient with a suspected lesion to determine the appropriate treatment plan.
10. A provider performs an open biopsy of the vertebral body in the thoracic spine on a patient with a suspected infection to guide the selection of appropriate antibiotics.