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The Current Procedural Terminology (CPT ®) code 20936 as maintained by American Medical Association, is a medical procedural code under the range - General Grafts (or Implants) Procedures on the Musculoskeletal System.
The official description of CPT code 20936 is: “Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same incision (List separately in addition to code for primary procedure)”.
CPT code 20936 is used for a surgical procedure involving a spinal bone graft. This code specifically refers to the use of a local bone graft, which means the bone used for the graft is taken from the same surgical site or nearby area.
For spinal grafts, the applicable autograft codes are: +20936 Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same incision (List separately in addition to code for primary procedure)
This section shows APC information including: Status Indicator, Relative Weight, Payment Rate, Crosswalks, and more. View fees for this code from 4 different built-in fee schedules and from those you've added using the Compare-A-Fee™ tool.
Select Health will not reimburse codes 20930 and 20936 as they are considered ‘B’ status codes. Select Health may reimburse codes 20931, 20937, 20938, and/or 20939, however, only one unit of each code can be allowed per operative session, regardless of the number of vertebral levels fused.
CPT code 20936 represents the use of an autograft during spine surgery. This code is used to bill for procedures where the surgeon harvests bone tissue from the patient’s own body, obtained from the same incision, and utilizes it to fill bony defects in the spine.
CPT® Assistant (January 2001, page 12) states that these codes can be reported in addition to the fusion code if performed for decompression (apply modifier -59 to the decompression code). NOTE: CPT codes 63030 and 63047 are bundled per National Correct Coding Initiative (NCCI) edits with code 22633.
CPT code 20936 is for a spinal bone graft, local, add-on. It is used to describe a specific medical procedure for billing and documentation.
Code 20936 is an add on code describing grafting from a donor area using the same incision during a major operative procedure and must be reported with an allowable primary spinal procedure code. You should never append modifier 50, Bilateral procedure, to 20936.