How To Use CPT Code 20937

CPT code 20937 describes the use of an autograft for spine surgery, specifically for filling in bony defects. 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 20937?

CPT 20937 is a code used to describe the use of an autograft for spine surgery. Specifically, it involves the harvesting of the graft and its morselization, which means crushing it into granules of various shapes and sizes. The autograft is then used to fill in bony defects during the surgical procedure.

2. Official Description

The official description of CPT code 20937 is: ‘Autograft for spine surgery only (includes harvesting the graft) morselized (through separate skin or fascial incision) (List separately in addition to code for primary procedure)’

3. Procedure

During a spine surgery procedure, the healthcare provider uses an autograft to fill in bony defects. The autograft is obtained from the patient’s own body through a separate incision. The provider selects and prepares the donor area, such as the iliac crest, rib, or femoral head. A longitudinal incision is made, and the superficial skin, fascia, and muscles are incised and retracted to expose the bone for grafting. The provider then localizes the donor site and uses an osteotome or bone shaver to shave and pull the graft. Sufficient bone pieces are obtained for the graft, and the donor site incision is closed with sutures. The autograft is then prepared outside the patient’s body by morselizing it into granules of various shapes and sizes. These granules are used to fill in the bony defects during the surgical procedure.

4. Qualifying circumstances

CPT 20937 is used when an autograft is harvested and morselized for spine surgery. It is typically performed when there are bony defects that need to be filled in during the procedure. The autograft is obtained from the patient’s own body through a separate incision, and the morselized bone pieces are used to fill in the gaps or cavities in the bone. This code should be used in conjunction with the primary procedure code for the spine surgery.

5. When to use CPT code 20937

CPT code 20937 should be used when the healthcare provider performs spine surgery and utilizes an autograft to fill in bony defects. The autograft must be harvested and morselized through a separate incision. This code should be reported in addition to the primary procedure code for the spine surgery.

6. Documentation requirements

To support a claim for CPT code 20937, the healthcare provider must document the following information:

• Indication for spine surgery and the need for bony defect filling
• Specific details of the autograft harvesting and morselization procedure
• Date and time of the procedure
• Details of the bony defects filled with the autograft
• Any additional relevant information or complications
• Signature of the healthcare provider

7. Billing guidelines

When billing for CPT code 20937, ensure that the autograft is harvested and morselized through a separate incision during spine surgery. This code should be reported in addition to the primary procedure code for the spine surgery. Modifier 50, Bilateral procedure, should not be appended to CPT code 20937. If the procedure is performed bilaterally, report the code twice. It is important to review the CMS Physician Fee Schedule Database for any specific instructions or indicators related to billing for CPT code 20937.

8. Historical information

CPT code 20937 was added to the Current Procedural Terminology system on January 1, 1996. There was a code change on January 1, 2008, which clarified the description of the code.

9. Similar codes to CPT 20937

There are several similar codes to CPT code 20937 that are used for different procedures on the musculoskeletal system. Some examples include:

• CPT 20936: Autograft for spine surgery only (includes harvesting the graft) local (eg, ribs, spinous process, or laminar fragments) obtained from same incision (List separately in addition to code for primary procedure)
• CPT 20938: Autograft for spine surgery only (includes harvesting the graft) local (eg, ribs, spinous process, or laminar fragments) obtained from separate incision (List separately in addition to code for primary procedure)
• CPT 20939: Autograft for spine surgery only (includes harvesting the graft) local (eg, ribs, spinous process, or laminar fragments) obtained from separate incision (List separately in addition to code for primary procedure); each additional contiguous vertebral segment (List separately in addition to code for primary procedure)

9. Examples

1. A surgeon performing spine surgery uses CPT code 20937 to report the harvesting and morselization of an autograft to fill in bony defects during the procedure.
2. During a spinal fusion surgery, the healthcare provider utilizes CPT code 20937 to document the use of an autograft for filling in bony defects.
3. A patient undergoes spine surgery, and the surgeon reports CPT code 20937 for the harvesting and morselization of an autograft to fill in bony defects.
4. During a laminectomy procedure, the healthcare provider uses CPT code 20937 to report the use of an autograft for filling in bony defects.
5. A surgeon performs spine surgery and utilizes CPT code 20937 to document the harvesting and morselization of an autograft for filling in bony defects.
6. During a spinal fusion surgery, the healthcare provider reports CPT code 20937 for the use of an autograft to fill in bony defects.
7. A patient undergoes spine surgery, and the surgeon utilizes CPT code 20937 to document the harvesting and morselization of an autograft for filling in bony defects.