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Orthopedic Coding Alert

Reader Question:

Designate Bone Marrow Aspiration with Subtalar Arthrodesis

Question: Our foot surgeon is performing a subtalar arthrodesis 28725 (Arthrodesis; subtalar), and in addition, he is aspirating bone marrow from the proximal medial tibia. The bone marrow is spun down to concentrated bone marrow cells and mixed with the bone graft. He then injects this into the fusion site. He wants to code 38220 (Bone marrow; aspiration only) for the bone marrow aspiration and 20552 (Injection[s]; single or multiple trigger point[s], 1 or 2 muscle[s]) for the injection. Is this choice of codes appropriate? Would these procedures be included in the subtalar arthrodesis?Alaska SubscriberAnswer: You are correct in the choice of 28725 for the subtalar arthrodesis. This code does not include the bone marrow aspiration, so you can report 38220. The placement of the bone marrow is however included in the code and you will hence not report 20552.

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