CPT code 20902 is for the removal of bone for graft, a procedure where bone is taken from one area to be used in another.
CPT code 20902 is used for the procedure involving the removal of bone from one part of the body to be used as a graft in another part. This code specifically refers to the harvesting of bone tissue, which can be used in various surgical procedures to aid in bone repair or reconstruction.
For CPT code 20902 (Removal of bone for graft), the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 - Increased Procedural Services
- Use this modifier if the procedure required significantly greater effort than typically required. This could be due to factors such as patient condition or complexity of the procedure.
2. Modifier 50 - Bilateral Procedure
- Apply this modifier if the procedure was performed on both sides of the body during the same operative session.
3. Modifier 51 - Multiple Procedures
- Use this modifier when multiple procedures are performed during the same surgical session. This indicates that 20902 was one of several procedures performed.
4. Modifier 59 - Distinct Procedural Service
- This modifier is used to indicate that the procedure was distinct or independent from other services performed on the same day. It can be used when the bone graft removal is performed in a different anatomical site or through a separate incision.
5. Modifier 76 - Repeat Procedure by Same Physician
- Apply this modifier if the same procedure was repeated by the same physician on the same day.
6. Modifier 77 - Repeat Procedure by Another Physician
- Use this modifier if the procedure was repeated by a different physician on the same day.
7. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period
- This modifier is used if the patient needs to return to the operating room for a related procedure during the postoperative period of the initial surgery.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Apply this modifier if the procedure is performed during the postoperative period of another surgery but is unrelated to the initial procedure.
9. Modifier LT - Left Side
- Use this modifier to specify that the procedure was performed on the left side of the body.
10. Modifier RT - Right Side
- Use this modifier to specify that the procedure was performed on the right side of the body.
11. Modifier 62 - Two Surgeons
- Apply this modifier if two surgeons worked together as primary surgeons performing distinct parts of the procedure.
12. Modifier 66 - Surgical Team
- Use this modifier if the procedure required the services of a surgical team.
Each of these modifiers provides additional information that can affect reimbursement and ensure accurate documentation of the services provided. Always refer to the latest CPT guidelines and payer-specific policies to confirm the appropriate use of modifiers.
Medicare does reimburse for CPT code 20902, which pertains to the removal of bone for graft. The reimbursement amount can vary based on several factors, including geographic location and the specific Medicare Administrative Contractor (MAC) overseeing the claim. As of the latest available data, the national average reimbursement for CPT code 20902 is approximately $300. However, it is essential to verify the exact amount with the relevant MAC or through the Medicare Physician Fee Schedule (MPFS) for the most accurate and up-to-date information.
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