Coding & Billing for Spine Allografts

Although allografts are up-and-coming in all orthopedic and spine situations, there isn’t CPT coding in orthopedics yet to capture these procedures, said Carolyn Neumann, senior manager of coding and coverage access for Specialty Healthcare Advisers said at the 12th Annual Spine, Orthopedic and Paine Management-Driven ASC Conference in Chicago.

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Orthopedic repair and augmentation procedures, for instance, have no separate CPT coding for the application of allograft. Ms. Neumann said the possible use of modifier 22 or the use of an unlisted code (which will require payer review) are the options if allograft application increases service significantly. Some allograft products also have “Q” codes.

 

These options are something providers should consider when developing contracts with payers, according to Ms. Neumann.

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