The degree of the injury can vary from a small crack to In order to obtain coverage and reimbursement for specific patients indicated for these procedures, the physician typically will need to use the CPT code for an unlisted procedure (see Coding practice will vary by site of care, patient condition, range of services provided, local payer instructions, and other factors. Navigate osteochondral autograft transplantation billing with our comprehensive guide to codes, guidelines, and reimbursement processes. To help answer common coding and reimbursement questions about endoscopic, arthroscopic, or open procedures completed with the BioSurge convenience kit, the following information is shared for The 2019 CPT® codebook introduced three new, add-on codes to report bone allograft: + 20932 Allograft, includes templating, cutting, placement Osteochondral Allograft Convenience Kit Coding Reference Guide An Osteochondral lesion is an injury to the smooth surface on the end of bones, including damage to both the cartilage and the underlying CPT® copyright 2020 American Medical Association. An Osteochondral lesion is an injury to the smooth surface on the end of bones, including damage to both the cartilage and the underlying bone. APCs provide a single payment for the primary service and all Find Coding Guides from Zimmer Biomet on this page. Please see the Policy Cro s References section above for other applicable medical policies. CPT is a registered trademark of the American Medical Association. CPT®a co es 27415 and Before you can choose the proper osteochondral graft code, you have to decide whether the surgeon used an autograft or allograft. Autograft: An autograft refers to a graft the surgeon takes Note: HCPCS codes report devices used in conjunction with outpatient procedures billed and paid for under Medicare’s Outpatient Prospective Payment System. ment Classification (APC). In the case of autografts, one or more small osteochondral plugs are Use Case: Used for osteochondral lesions (OCD) of the talus in the ankle joint. All rights reserved. Hier sollte eine Beschreibung angezeigt werden, diese Seite lässt dies jedoch nicht zu. The most common CPT codes used when an allograft is used as part of a knee procedure are 27415 or 29867. Plan’s use of evidence-based processes for policy development. 2025 Coding and Reimbursement Guidelines To help answer common coding and reimbursement questions about arthroscopic procedures completed with the OATS technique, the following nd CPT code 29892 is also used for other procedures of the ankle. Since there are not fully established coverage criteria for either osteochondral allografts or osteochondral autografts (aka, mosaicplasty or Helpful Codes For Osteochondral Allograft Procedures In The Shoulder The following coverage, coding, and payment information is provided for informational purposes only and should not be construed as Hier sollte eine Beschreibung angezeigt werden, diese Seite lässt dies jedoch nicht zu. See Table 1 below for addition Zimmer Biomet Coding Reference Guide Disclaimer Providers, not Zimmer Biomet, are solely responsible for ensuring compliance with Medicare, Medicaid, and all other third-party payer Policy Scope of Policy This Clinical Policy Bulletin addresses allograft transplants of the extremities. Note: While this code is primarily for Take home message Osteochondral allograft (OCA) transplan-tation shows promise as a treatment for shoulder instability, addressing defects in both the glenoid and humeral head. As a minimally manipulated human tissue graft, the Chondrofix Osteochondral Disclaimer: The guidance contained in this document, dated January 2024, is provided for informational purposes only and represents no statement, promise, or guarantee by BioTissue Holdings Inc. Cartiform® Viable Osteochondral Allograft Reimbursement Guide 2025 English | 05/09/2025 | DOC1-001754-en-US A Hier sollte eine Beschreibung angezeigt werden, diese Seite lässt dies jedoch nicht zu. Shoulder Joint CPT 29806: Arthroscopy, shoulder, surgical; capsulorrhaphy. or its . The decision as to how to complete a reimbursement claim form, Coding Guidelines The following HCPCS codes are associated with Cartiform® viable osteochondral allograft: ly assigned to identify Cartiform viable osteochondral allograft. Medical Necessity Allograft Transplant of the Knee Aetna considers allograft transplant of the knee Description: Osteochondral autografts and allografts are used in repair of full-thickness chondral defects involving the knee joint. eviCore: Comprehensive Joint Surgery Prior Authorization CPT Code List Category CPT® Code CPT® Code Description Guide Chondrofix® Osteochondral Allograft is a decellularized allograft consisting of hyaline cartilage and cancellous bone.
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