AMA CPT® Assistant - 2006 Issue 9 (September)

Surgery: Musculoskeletal System (September 2006)

September 2006 page 13b Surgery: Musculoskeletal System, 21076, 21089 (Q&A) Question Is it appropriate to report a code from the 21076-21089 code series when the prosthesis is made by an outside laboratory? AMA Comment The 21076-21089 code series should only be reported when a physician actually designs and prepares the prosthesis. These codes represent the professional service rendered by a physician in custom design and fabrication of the listed prosthesis. Therefore, it is not appropriate to report these codes when the work is performed by an outside laboratory rather than a physician. Surgery: Musculoskeletal System, 21076, 21089 (Q&...

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CPT® Assistant content is the official source for CPT® coding guidance. It is an instrumental tool when appealing insurance denials and validating coding to auditors. Monthly issues and an extensive archive provide comprehensive guidance on proper CPT® coding for past, present and upcoming code set releases. Archives date back to 1990 for historical use of codes, changes, rationales, coding tips and trends in the industry.

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