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The procedure described by CPT® Code 20957 involves the harvesting of a bone graft specifically from the metatarsal region of the foot. This process is essential for reconstructive surgery, where the harvested bone is utilized to fill a defect at another anatomical site. During the procedure, the physician carefully isolates and dissects the donor bone while ensuring that the associated blood vessels remain intact. This is crucial as the viability of the graft depends on the preservation of its blood supply. After the bone graft is harvested, the donor site is meticulously closed in layers to promote proper healing and minimize complications. Subsequently, the graft is positioned at the defect site, where the blood vessels from the graft are anastomosed, or surgically connected, to the vessels in the defect area. This connection is vital for ensuring that the graft receives adequate blood flow, which is necessary for its integration and healing. Finally, the defect area is also closed with layered sutures, completing the procedure. This code is specifically designated for cases where the donor site is the metatarsal, distinguishing it from other codes that pertain to grafts taken from different anatomical locations, such as the fibula or iliac crest.
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The procedure associated with CPT® Code 20957 is indicated for various conditions that necessitate the use of a bone graft for reconstruction. The following are explicitly provided indications for this procedure:
The procedure for CPT® Code 20957 involves several critical steps that ensure the successful harvesting and application of the bone graft. The following procedural steps are outlined:
Post-procedure care following the harvesting of a bone graft using CPT® Code 20957 is essential for ensuring proper recovery and minimizing complications. Patients are typically monitored for any signs of infection or complications at both the donor and defect sites. Pain management strategies are implemented to address discomfort following the procedure. Patients may be advised to limit weight-bearing activities on the affected foot to promote healing. Follow-up appointments are scheduled to assess the healing process and the integration of the graft. Additionally, physical therapy may be recommended to restore function and strength in the affected area as healing progresses.
| Short Descr | MT BONE GRAFT MICROVASC | Medium Descr | BONE GRAFT MICROVASCULAR ANAST METATARSAL | Long Descr | Bone graft with microvascular anastomosis; metatarsal | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5B - Ambulatory procedures - musculoskeletal | MUE | 1 | CCS Clinical Classification | 161 - Other OR therapeutic procedures on bone |
| 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | F5 | Right hand, thumb | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 2011-01-01 | Changed | Short description changed. |
| 1997-01-01 | Added | First appearance in code book in 1997. |
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