How To Use CPT Code 20922

CPT code 20922 describes the procedure of harvesting a fascia lata graft through an incision and area exposure. 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 20922?

CPT 20922 is a code used to describe the procedure of harvesting a fascia lata graft through an incision and area exposure. The fascia lata, which is the deep fascia of the thigh, is a valuable source of graft for repairing ruptured tendons, chest wall defects, eyelid and orbital defects, and for treating fecal incontinence through unilateral gluteoplasty. The provider performs a complex or larger sheet graft harvest through an open excision procedure.

2. Official Description

The official description of CPT code 20922 is: ‘Fascia lata graft by incision and area exposure, complex or sheet.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider makes a longitudinal incision over the thigh in the upper lateral part, extending it to the level of the fascia lata.
3. Extra care is taken to avoid incising the muscle.
4. The provider dissects the fascia free from the upper fat pad and the muscle beneath.
5. The dissection is extended to the distal lower level medially and laterally to obtain the desired width of the fascial sheet.
6. The provider detaches the fascia through transverse cuts made distally and proximally at the desired length.
7. After harvesting the fascia lata sheet, the incision is sutured in a layered fashion.

4. Qualifying circumstances

CPT 20922 is performed when there is a need for a fascia lata graft to repair ruptured tendons, chest wall defects, eyelid and orbital defects, or for the treatment of fecal incontinence through unilateral gluteoplasty. The procedure involves a complex or larger sheet graft harvest through an open excision. It is important to note that this code should not be reported if the graft or implant harvesting is separately coded, unless the code descriptor specifically includes obtaining the graft.

5. When to use CPT code 20922

CPT code 20922 should be used when the provider performs a fascia lata graft harvest through an incision and area exposure. This code is appropriate for complex or larger sheet grafts obtained during an open excision procedure. It should not be reported if the graft or implant harvesting is separately coded, unless the code descriptor specifically includes obtaining the graft.

6. Documentation requirements

To support a claim for CPT 20922, the provider must document the following information:

• Patient’s diagnosis and the need for a fascia lata graft
• Details of the incision and area exposure
• Specific technique used for the graft harvest
• Length and width of the harvested fascial sheet
• Method of closure for the incision
• Any additional procedures performed in conjunction with the graft harvest
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 20922, ensure that the procedure involves the harvest of a fascia lata graft through an incision and area exposure. It is important to note that if the graft or implant harvesting is separately coded, CPT 20922 should not be reported unless the code descriptor specifically includes obtaining the graft. Additionally, modifier 62, Two surgeons, should not be appended to bone graft codes in the General Grafts or Implants section (20900 to 20938) even if more than one provider performs the surgery.

8. Historical information

CPT 20922 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A provider performs a fascia lata graft harvest through an incision and area exposure to repair a ruptured Achilles tendon.
2. A patient undergoes a fascia lata graft harvest through an incision and area exposure to treat a chest wall defect.
3. A provider performs a fascia lata graft harvest through an incision and area exposure to repair an eyelid defect.
4. A patient undergoes a fascia lata graft harvest through an incision and area exposure to treat fecal incontinence through unilateral gluteoplasty.
5. A provider performs a fascia lata graft harvest through an incision and area exposure to repair an orbital defect.
6. A patient undergoes a fascia lata graft harvest through an incision and area exposure to treat a chest wall defect.
7. A provider performs a fascia lata graft harvest through an incision and area exposure to repair a ruptured Achilles tendon.
8. A patient undergoes a fascia lata graft harvest through an incision and area exposure to treat fecal incontinence through unilateral gluteoplasty.
9. A provider performs a fascia lata graft harvest through an incision and area exposure to repair an eyelid defect.
10. A patient undergoes a fascia lata graft harvest through an incision and area exposure to repair an orbital defect.