2025 CPT code 20969
Effective Date: N/A Surgical Procedures on the Musculoskeletal System - Musculoskeletal System Surgery Feed
Free osteocutaneous flap with microvascular anastomosis; other than iliac crest, metatarsal, or great toe
Modifiers may be applicable to indicate specific circumstances, such as increased procedural services (22), reduced services (52), or staged procedures (58).
Medical necessity is established by documenting the specific medical condition requiring the bone graft, such as a significant bone defect resulting from trauma, infection, tumor resection, or congenital anomaly. The chosen donor site and the rationale for using a free osteocutaneous flap should also be justified.
The physician performs the surgery, including incision, bone graft harvesting, microvascular anastomosis, and closure of both donor and recipient sites.They also ensure the graft's viability and proper placement.
In simple words: The surgeon takes a piece of bone, along with its blood supply and overlying skin, from one part of the body (other than the hip, foot bones, or big toe) and moves it to another area. Tiny blood vessels are reconnected under a microscope to keep the transplanted bone alive.
Harvesting of a bone graft with its attached skin and blood supply from a donor site other than the iliac crest, metatarsal, or great toe, and transplanting it to a recipient site using microsurgical techniques to reconnect the blood vessels.
Example 1: A patient with a large bone defect in their arm following a traumatic injury requires a bone graft to promote healing and restore function.A free osteocutaneous flap is harvested from the fibula (lower leg bone) and transplanted to the arm., A patient with bone loss in the jaw due to infection needs reconstructive surgery. A free osteocutaneous flap is taken from the scapula (shoulder blade) and used to rebuild the jawbone., A patient has a non-healing wound with exposed bone in the leg. A free osteocutaneous flap from the rib is used to cover the exposed bone and provide soft tissue coverage, facilitating wound closure.
Documentation should include the size and location of the bone defect, the donor site location, operative details of the graft harvest and transfer, including the type of microvascular anastomosis performed, and any complications encountered. Evidence of medical necessity should also be documented.
- Revenue Code: P5B
- Specialties:Plastic Surgery, Orthopedic Surgery, Reconstructive Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center