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The CPT® Code 20934 refers to the procedure of inserting an allograft, which is a graft derived from a donor (typically cadaveric tissue), to reconstruct a bone or soft tissue deficit. This procedure is particularly relevant in cases where there is a need to address significant structural loss due to various medical conditions such as tumors, osteochondral cysts, posttraumatic or degenerative arthritis, traumatic injuries, or avascular necrosis. The primary goal of utilizing an allograft in these scenarios is to prevent limb amputation and to preserve the functionality of the limb. The allograft used in this procedure is often composed of bone, cartilage, or other tissues that are anatomically similar to the tissue that has been excised from the patient. During the procedure, the surgeon accesses the affected area, resects the damaged or diseased tissue down to viable healthy bone or tissue, and then prepares the allograft. The allograft is sculpted to match the contours of the removed tissue, using the excised bone or tissue as a template. Once shaped, the allograft is inserted into the prepared site and secured in place using various fixation methods, which may include rods, cerclage wires, intramedullary nails, plates, or screws. This procedure is categorized as intercalary, complete (cylindrical), meaning that a section of the diaphyseal portion of the bone is entirely removed, and the allograft serves to bridge the gap between the remaining ends of the native bone. It is important to note that this code is used in conjunction with the primary procedure code for radical resection of the diseased bone or joint or for the removal of an implant.
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The procedure associated with CPT® Code 20934 is indicated for the following conditions:
The procedure for CPT® Code 20934 involves several critical steps to ensure successful allograft placement:
Post-procedure care for patients undergoing the allograft placement involves monitoring for any signs of complications, such as infection or graft failure. Patients may require rehabilitation to regain strength and mobility in the affected limb. The recovery process will vary depending on the extent of the surgery and the individual patient's condition. Follow-up appointments are essential to assess the integration of the allograft and to ensure proper healing. Additionally, patients may need to adhere to specific weight-bearing restrictions and physical therapy protocols as directed by their healthcare provider.
| Short Descr | INTERCALARY ALGRFT COMPL | Medium Descr | INTERCALARY ALLOGRAFT COMPLETE | Long Descr | Allograft, includes templating, cutting, placement and internal fixation, when performed; intercalary, complete (ie, cylindrical) (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No 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 | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 23210 | MPFS Status: Active Code APC C Illustration for Code Radical resection of tumor; scapula | 23220 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Radical resection of tumor, proximal humerus | 24150 | MPFS Status: Active Code APC J1 CPT Assistant Article Illustration for Code Radical resection of tumor, shaft or distal humerus | 25170 | MPFS Status: Active Code APC J1 CPT Assistant Article Illustration for Code Radical resection of tumor, radius or ulna | 27075 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Radical resection of tumor; wing of ilium, 1 pubic or ischial ramus or symphysis pubis | 27076 | MPFS Status: Active Code APC C Illustration for Code Radical resection of tumor; ilium, including acetabulum, both pubic rami, or ischium and acetabulum | 27077 | MPFS Status: Active Code APC C Illustration for Code Radical resection of tumor; innominate bone, total | 27365 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Radical resection of tumor, femur or knee | 27645 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Radical resection of tumor; tibia | 27704 | MPFS Status: Active Code APC Q2 ASC A2 Illustration for Code Removal of ankle implant |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 2019-03-06 | Changed | Per CPT Errata, several codes in the Guidelines deleted. |
| 2019-01-01 | Added | Added |
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