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Anesthesia Coding Alert

Reader Question:

Coding for Prolotherapy

Published on Wed Aug 01, 2001

Question: How should we code prolotherapy?

California Subscriber
 
Answer: Prolotherapy, also known as sclerotherapy, is a series of injections into soft tissue or tendons to treat back, neck or joint pain. Medicare does not cover this procedure, but private payers might accept codes for tendon injections such as 20550* (injection, tendon sheath, ligament, trigger points or ganglion cyst). Because no CPT code specifically applies to the procedure, your other option is to use 90799 (unlisted therapeutic, prophylactic or diagnostic injection). Because Medicare and some other carriers dont pay for prolotherapy, have the patient sign an advance beneficiary notice (ABN) that states he or she understands the procedure is not covered and commits to paying for the services.
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