How To Use CPT Code 20910

CPT 20910 describes the procedure of cartilage grafting, specifically using a costochondral or rib cartilage graft, to fill larger defects in cartilage or bones such as the temporomandibular joint. 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 20910?

CPT 20910 is a code used to describe the procedure of cartilage grafting, specifically using a costochondral or rib cartilage graft. This procedure is performed to fill larger defects in cartilage or bones, such as those found in the temporomandibular joint, nose, or trachea. The provider makes an incision over the rib area donor site, exposes the bone, and extracts a large oval shape of cartilage using a rongeur or bone shaver. The cartilage graft is then used to fill major bone and cartilage defects.

2. Official Description

The official description of CPT code 20910 is: ‘Cartilage graft costochondral.’

3. Procedure

The procedure for CPT code 20910 involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. The provider makes an incision over the rib area donor site.
3. The incision is extended down to the fascia and underlying muscles.
4. A surgical retractor is used to pull back soft tissue, fascia, and muscles to expose part of the bone.
5. The provider incises, shaves, and extracts a large oval shape of cartilage using a rongeur or bone shaver.
6. The cartilage graft is used to fill major bone and cartilage defects.
7. The wound at the donor site is closed by suturing in a layered fashion.

4. Qualifying circumstances

CPT 20910 is performed when there is a need to fill larger defects in cartilage or bones using a costochondral or rib cartilage graft. This procedure is commonly used in the reconstruction of facial defects, including those of the nose and temporomandibular joint, as well as in the repair of the trachea. The patient must have a suitable donor site for the cartilage graft, typically the fifth or sixth rib. It is important for the provider to ensure that there is enough cartilage remaining in the patient’s ribs for the graft to be successful.

5. When to use CPT code 20910

CPT code 20910 should be used when performing a cartilage grafting procedure using a costochondral or rib cartilage graft to fill larger defects in cartilage or bones. It is important to accurately document the procedure and ensure that the patient meets the qualifying circumstances for this code.

6. Documentation requirements

To support a claim for CPT 20910, the following documentation is required:

• Patient’s medical record, including the need for cartilage grafting and the specific defect being addressed
• Description of the procedure performed, including the use of a costochondral or rib cartilage graft
• Date of the procedure
• Details of the incision, extraction of cartilage, and closure of the donor site
• Any additional procedures or techniques used during the cartilage grafting
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 20910, ensure that the procedure performed meets the requirements of the code. It is important to accurately document the procedure and provide the necessary supporting documentation. CPT code 20910 should not be reported with other codes unless additional procedures or techniques were performed during the cartilage grafting procedure.

8. Historical information

CPT code 20910 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 20910

There are no similar codes to CPT code 20910 within the range of general grafts (or implants) procedures on the musculoskeletal system (20900-20939).

9. Examples

1. A patient undergoes cartilage grafting using a costochondral graft to repair a defect in the temporomandibular joint.
2. A provider performs cartilage grafting using a rib cartilage graft to reconstruct a nasal defect.
3. A patient undergoes cartilage grafting using a costochondral graft to repair a tracheal defect.
4. A provider performs cartilage grafting using a rib cartilage graft to reconstruct a facial defect.
5. A patient undergoes cartilage grafting using a costochondral graft to repair a defect in the nose.
6. A provider performs cartilage grafting using a rib cartilage graft to reconstruct a temporomandibular joint defect.
7. A patient undergoes cartilage grafting using a costochondral graft to repair a defect in the trachea.
8. A provider performs cartilage grafting using a rib cartilage graft to reconstruct a facial defect.
9. A patient undergoes cartilage grafting using a costochondral graft to repair a defect in the nose.
10. A provider performs cartilage grafting using a rib cartilage graft to reconstruct a temporomandibular joint defect.