How To Use CPT Code 20939

CPT code 20939 describes the procedure of bone marrow aspiration for bone grafting in spine surgery, performed through a separate skin or fascial incision. 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 20939?

CPT 20939 is used to describe the bone marrow aspiration procedure for bone grafting in spine surgery. It involves the harvesting of bone marrow from the spongy tissue inside large bones to fill in bony defects in the spine. The aspiration is performed during the same session as the primary spinal surgery but through a separate skin or fascial incision.

2. Official Description

The official description of CPT code 20939 is: ‘Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision (List separately in addition to code for primary procedure).’ This code should be used in conjunction with specific primary procedure codes for spine surgery.

3. Procedure

The bone marrow aspiration procedure for bone grafting in spine surgery involves the following steps:

1. The provider prepares the separate site for bone marrow aspiration during the primary spinal surgery.
2. A small incision is made in the skin or through the fascia adjacent to the primary site.
3. A bone marrow aspiration needle is inserted through the incision.
4. The provider reaches the marrow cavity and aspirates the bone marrow.
5. The aspiration needle is removed, and any bleeding at the site is controlled.
6. The provider continues with the primary spinal procedure, transferring the bone marrow graft to fill the defect in the spine.

4. Qualifying circumstances

CPT 20939 is used when bone marrow aspiration is performed for bone grafting in spine surgery. It is important to note that this code should only be reported in conjunction with specific primary procedure codes for spine surgery. The bone marrow aspiration must be performed through a separate skin or fascial incision.

5. When to use CPT code 20939

CPT code 20939 should be used when bone marrow aspiration is performed for bone grafting in spine surgery. It is important to ensure that the procedure is performed through a separate skin or fascial 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 20939, the following documentation is required:

• Documentation of the primary spinal surgery procedure
• Description of the separate skin or fascial incision made for bone marrow aspiration
• Date and time of the bone marrow aspiration procedure
• Details of the bone marrow aspiration technique
• Documentation of any bleeding control measures taken
• Documentation of the transfer of the bone marrow graft to fill the defect in the spine

7. Billing guidelines

When billing for CPT 20939, it is important to ensure that the procedure is performed through a separate skin or fascial incision. This code should be reported in addition to the primary procedure code for the spine surgery. Modifier 50 should not be used in conjunction with CPT 20939. It is also important to follow any specific billing guidelines provided by the payer.

8. Historical information

CPT 20939 was added to the Current Procedural Terminology system on January 1, 2018. There have been no updates to the code since its addition.

9. Similar codes to CPT 20939

There are several similar codes to CPT 20939 that are used for different procedures. These include:

• CPT 22319: 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 22532: Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar
• CPT 22533: Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (List separately in addition to code for primary procedure)
• CPT 22534: Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below C2
• CPT 22548: Arthrodesis, posterior or posterolateral technique, single level; lumbar

9. Examples

1. A patient undergoes spine surgery for the treatment of a vertebral fracture. During the surgery, the provider performs bone marrow aspiration through a separate incision to obtain graft material for filling the defect in the spine. CPT code 20939 should be reported in addition to the primary procedure code for the spine surgery.
2. A patient undergoes spinal fusion surgery for the treatment of degenerative disc disease. The provider performs bone marrow aspiration through a separate fascial incision to obtain graft material for the fusion procedure. CPT code 20939 should be reported in addition to the primary procedure code for the spinal fusion.
3. A patient undergoes spinal decompression surgery for the treatment of spinal stenosis. The provider performs bone marrow aspiration through a separate skin incision to obtain graft material for filling the defect in the spine. CPT code 20939 should be reported in addition to the primary procedure code for the spinal decompression.