How To Use CPT Code 20930

CPT code 20930 describes the placement of allograft or osteopromotive material during spine surgery to promote bone growth. 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 20930?

CPT 20930 is used to describe the placement of allograft or osteopromotive material during spine surgery. This code is specifically for morselized allograft or synthetic bone substitute that is applied to areas where bone growth is desired. The purpose of this procedure is to encourage bone growth during the healing period after spinal surgery.

2. Official Description

The official description of CPT code 20930 is: ‘Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure).’ This code should be used in conjunction with other specific spine surgery codes, such as 22319, 22532, 22533, 22548-22558, 22590-22612, 22630, 22633, 22634, 22800-22812.

3. Procedure

During spine surgery, after the patient is appropriately prepped and anesthetized, the healthcare provider applies morselized allograft or synthetic bone substitute to areas where bone growth is desired. This material is placed to encourage natural bone growth in and around it. The provider then proceeds with the primary surgical procedure to its conclusion.

4. Qualifying circumstances

CPT 20930 is used for spine surgery procedures where the placement of allograft or osteopromotive material is necessary to promote bone growth. This code should only be used for specified spinal procedures and is not applicable to other types of surgeries. It is important to check with the payer to determine if CPT 20930 can be billed separately or if the application of the bone graft material is included in the code for the primary surgical procedure.

5. When to use CPT code 20930

CPT code 20930 should be used when the healthcare provider is performing a spine surgery procedure that requires the placement of allograft or osteopromotive material to promote bone growth. It is important to ensure that this code is only used for specified spinal procedures and not for other types of surgeries.

6. Documentation requirements

To support a claim for CPT 20930, the healthcare provider must document the following information:

• Specific spine surgery procedure performed
• Details of the placement of allograft or osteopromotive material
• Date of the procedure
• Start and end time of the procedure
• Any additional relevant information related to the procedure

7. Billing guidelines

When billing for CPT 20930, it is important to ensure that the procedure meets the qualifying circumstances and is performed during a specified spine surgery. This code should be listed separately in addition to the code for the primary procedure. It is also important to check with the payer to determine if the application of the bone graft material is included in the code for the primary surgical procedure or if it can be billed separately.

8. Historical information

CPT 20930 was added to the Current Procedural Terminology system on January 1, 1996. There have been a few historical changes to the code, including code changes in 2008 and 2011 to specify the use of morselized allograft for spine surgery only.

9. Similar codes to CPT 20930

There are several similar codes to CPT 20930 that are used for different procedures and purposes. Some of these codes include:

• CPT 22319: Autograft for spine surgery only
• CPT 22532: Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below C2
• CPT 22533: Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below C2, each additional interspace (List separately in addition to code for primary procedure)
• CPT 22548-22558: Arthrodesis, posterior or posterolateral technique, single level; lumbar
• CPT 22590-22612: Arthrodesis, posterior or posterolateral technique, single level; thoracic
• CPT 22630: Arthrodesis, posterior or posterolateral technique, single level; lumbar
• CPT 22633: Arthrodesis, posterior or posterolateral technique, single level; thoracic
• CPT 22634: Arthrodesis, posterior or posterolateral technique, single level; lumbar and thoracic
• CPT 22800-22812: Arthrodesis, posterior or posterolateral technique, single level; cervical below C2

9. Examples

1. A patient undergoing spinal arthrodesis for lumbar fusion receives morselized allograft during the procedure to promote bone growth.
2. During a spinal dislocation repair, the healthcare provider applies osteopromotive material to encourage bone growth in the affected area.
3. A patient undergoing spinal surgery for a vertebral fracture receives allograft to promote bone healing and fusion.
4. During a spinal fusion procedure, the healthcare provider uses synthetic bone substitute to encourage bone growth between the vertebrae.
5. A patient undergoing spinal surgery for degenerative disc disease receives morselized allograft to promote bone fusion.
6. During a spinal tumor resection, the healthcare provider applies osteopromotive material to encourage bone growth and stability after the tumor removal.
7. A patient undergoing spinal surgery for scoliosis receives allograft to promote bone fusion and stabilization of the spine.
8. During a spinal decompression procedure, the healthcare provider applies synthetic bone substitute to promote bone growth and stability.
9. A patient undergoing spinal surgery for spinal stenosis receives morselized allograft to promote bone fusion and alleviate symptoms.