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Coding tip: Know when you can bill for tendon grafts with ACL repair procedures

Ambulatory Surgery Reimbursement Update, August 14, 2007

You usually can't bill for tendon grafts when used for arthroscopic ACL repairs. However, under certain conditions you can. Read on to find out why.

The CPT Manual states that CPT code 20924, indicates a tendon graft obtained "from a distance." You cannot bill this code separately from CPT code 29888 (ACL repair where a tendon graft is obtained from a separate incision on the same knee, which is the standard in these types of procedures). This does not constitute a far enough distance to bill for it separately, according to the CPT Assistant.

The tendon graft procedure is only billable when the graft is obtained from the ankle area on the same leg, from the opposite knee, or from another distant area.

This tip is brought to you by Ellis Medical Consulting, Inc.

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