Multi-region CPT codes

Free osteocutaneous flap transfer with microvascular anastomosis, harvested from a donor site other than the iliac crest, metatarsal, or great toe, to reconstruct combined bone and soft tissue defects.

Add-on code for osteoarticular allograft reconstruction involving the articular surface and contiguous bone, including templating, cutting, shaping, placement, and internal fixation when performed.

Split-thickness skin autograft to the trunk, arms, or legs for the first 100 square centimeters, or 1 percent of body area in infants and children.

Removal of devitalized tissue down to and including bone, for the first 20 square centimeters of wound surface or less.

Nerve conduction studies totaling thirteen or more individual studies in a single session, with interpretation and report.

Excision of a benign skin lesion on the trunk, arm, or leg when the total excised diameter, including margins, is more than 4.0 cm.

Add-on for using an operating microscope during surgery when the microsurgical technique is not already part of the primary procedure.

Nerve conduction studies totaling eleven or twelve individual studies in one session, including interpretation and report.

Percutaneous drainage of a soft tissue fluid collection, such as an abscess, hematoma, or seroma, by placing a catheter under imaging guidance.

Removal of a foreign object from subcutaneous tissue through an incision when the removal takes more work, such as dissection or a hard-to-find fragment.

Removal of devitalized tissue down to and including muscle or fascia, for the first 20 square centimeters of wound surface or less.

Add-on code for manual preparation and intra-articular placement of a drug-delivery device (e.g., antibiotic-cement beads or rods) into a joint during a separately reported primary procedure.

Add-on code for imageless computer-assisted surgical navigation used during musculoskeletal procedures — reported in addition to the primary surgical code.

Incision and drainage of a complicated skin or subcutaneous abscess, or of several abscesses at one session.

MRI of a shoulder, elbow, or wrist joint done first without contrast and then repeated after IV contrast is given, usually for infection, tumor, or postoperative questions.

MRI of a lower extremity region other than a joint, done without contrast and then with contrast, often for a mass, infection, or tumor in the thigh, leg, or foot.

MRI of a hip, knee, or ankle joint done first without contrast and then with IV contrast, used for infection, tumor, inflammatory arthritis, or complex postoperative cases.

Application of a body cast extending from the shoulder down to one thigh, covering the trunk and upper leg.

Needle electromyography of all four extremities, including related paraspinal muscles if sampled, when no nerve conduction study is performed the same day.

Radiological supervision and interpretation of a catheter angiogram of the arteries in both arms or both legs.

CT angiography of one lower extremity with contrast, including any non-contrast images and the image post-processing, to map the arteries of the leg.

Needle electromyography of three extremities, with related paraspinal muscles included when sampled, performed on a day with no nerve conduction testing.

Magnetic resonance angiography of a lower extremity, with or without contrast, to evaluate leg arteries or veins for occlusion, injury, or vascular malformation.

Radiological supervision and interpretation of a catheter angiogram of the arteries in one arm or one leg.

Magnetic resonance angiography of an upper extremity, with or without contrast, to evaluate the arteries or veins of the arm for blockage, injury, or compression.

Add-on for each extra 100 square centimeters, or 1 percent of body area in children, of split-thickness skin autograft to the trunk, arms, or legs.

MRI of a hip, knee, or ankle joint performed with contrast only, including MR arthrograms where contrast is placed directly into the joint.

Magnetic resonance imaging to evaluate bone marrow blood supply, assessing marrow perfusion and composition across one or more regions.

Opening and draining a collection of blood, serum, or other fluid that has built up in the skin or subcutaneous tissue.

Needle electromyography of two extremities, including the related paraspinal muscles when they are sampled, performed without a same-day nerve conduction study.

Application of a skin substitute graft to a wound on the trunk, arms, or legs, total wound area up to 100 sq cm, for the first 25 sq cm or less.

Radiologic supervision and interpretation of CT used to guide a needle into position, most often for a biopsy, aspiration, or localization.

Radiologic supervision and interpretation of MRI used to guide a needle into position for a biopsy, aspiration, injection, or localization.

Osteopathic manipulative treatment performed by a physician (usually a DO) across 9 to 10 separate body regions during a single encounter, based on documented somatic dysfunction in each region.

MRI of any upper extremity joint — shoulder, elbow, or wrist — performed without contrast material.

MRI of an upper extremity region other than a joint, done without contrast, such as the forearm or upper arm, for masses, muscle injury, or soft tissue problems.

Removal or bivalving of a shoulder spica, hip spica, Minerva jacket, or Risser jacket cast applied by a different provider.

Incision and drainage of one uncomplicated skin or subcutaneous abscess, cyst, boil, or nail fold infection.

Cutting into the skin to remove a foreign object lodged in subcutaneous tissue when the removal is straightforward.

Osteopathic manipulative treatment performed by a physician (usually a DO) across 7 to 8 separate body regions during a single encounter, based on documented somatic dysfunction in each region.

CT scan of an upper extremity performed with intravenous contrast only, used when the clinician needs to see soft tissue enhancement, infection, or a mass in the arm.

Intermediate radiation therapy simulation used to set up treatment fields, generally covering two separate treatment areas before radiation delivery.

Three-phase nuclear medicine bone scan capturing blood flow, blood pool, and delayed bone images to evaluate a specific area of concern.

Aspiration and/or injection of an intermediate joint or bursa — such as the wrist, elbow, ankle, acromioclavicular, temporomandibular, or olecranon bursa — performed with real-time ultrasound guidance and permanent image recording and reporting.

Osteopathic manipulative treatment performed by a physician (usually a DO) across 5 to 6 separate body regions during a single encounter, based on documented somatic dysfunction in each region.

Complete real-time diagnostic ultrasound of one extremity joint, with recorded images, covering the joint, surrounding muscles, tendons, and other soft tissue structures.

Nuclear medicine bone scan imaging multiple areas of the skeleton after injection of a bone-seeking radiotracer, using planar images.

Aspiration and/or injection of a major joint or bursa (shoulder, hip, knee, or subacromial bursa) performed without ultrasound guidance.

Removal or bivalving of a full arm or full leg cast, applied by a different provider than the one performing the removal.

Injection of anesthetic, steroid, or both around a peripheral nerve or branch that does not have its own specific nerve block code.

Pathologist's gross and microscopic exam of a surgical tissue specimen at the level IV complexity tier, billed per specimen submitted.

Osteopathic manipulative treatment performed by a physician (usually a DO) across 3 to 4 separate body regions during a single encounter, based on documented somatic dysfunction in each region.

Limited real-time diagnostic ultrasound focused on a specific joint area or a single non-vascular extremity structure, such as one tendon, a ganglion, or a soft tissue mass.

Repair of a spica cast, body cast, or jacket cast that has deteriorated, cracked, or loosened and requires reinforcement to maintain proper immobilization.

Biopsy of one skin lesion by shaving, scooping, or curetting tissue from the surface, without a full-thickness sample.

Noninvasive electrical stimulation applied to promote bone healing without surgical implantation of the stimulating device.

Removal or bivalving of a gauntlet, boot, or body cast — billable only when the removing provider did not apply the original cast.

Complete radiographic bone survey imaging the axial and appendicular skeleton, used to map lytic lesions, metastases, or systemic bone disease.

Injection of medication directly into skin lesions, covering up to and including seven lesions at one session.

Training to improve walking, including stair climbing and use of assistive devices, billed in 15-minute units of direct contact.