Bone Marrow Harvest for Ankle Arthrodesis

Question:

Our surgeon harvested bone from the calcaneus (same incision) and also harvested bone marrow from the iliac crest for an ankle arthrodesis. We know the bone graft from the calcaneus is not reportable. Is the bone marrow aspirate reportable? If yes, what CPT code do you recommend?

Answer:

You are correct that bone graft harvested via the same incision is not separately reportable. CPT instructs to report 20999 for the bone marrow harvest when performed for an arthrodesis in musculoskeletal system, excluding spine.

Based on your inquiry the correct code for the ankle arthrodesis is 27870 (Arthrodesis, ankle, open). Your reportable codes are 27870 and 20999.

Note, there are no NCCI edits between 27870 and 20999. Consider adding modifier 59 if necessary to indicate the bone marrow aspirate was from a different location, separate incision.

KZA recommends using 20939 as the comparison code for 20999.

*This response is based on the best information available as of 2/27/25.