Wiki What is included in PRP injections?

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mireyitadauto

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Some of our physicians are performing tendon fenestrations, tenotomies, and patellar fat pad hydro dissections when performing PRP injections. Our physician believes these services are included in the PRP injection and not separately coded/billed. There is no guidance from the AMA/AHA or other reliable resource that can help support or refute this. Being that this is a cash item, how are you treating the other procedures when performed in conjunction with PRP's?
 
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The primary CPT code for Platelet-Rich Plasma (PRP) injections is 0232T, which covers the entire process, including blood harvesting, PRP preparation, injection, and any associated image guidance. This is a Category III code, indicating it represents emerging technology and is not always covered by insurance, so accurate paperwork and verification with the payer are crucial before performing the service.
 
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Thank you for your response. We understand that blood collection, preparation, injection and image guidance are bundled within 0232T. We were hoping to clarify how this applies to additional procedures performed with PRP, such as a tenotomy or a fat pad hydro dissection using the PRP injectate. Since there is no specific guidance indicating whether these are bundled or separately coded, it is challenging to make that determination without clear direction from the AMA. We also do not bill insurance for PRP injections, as many payers do not cover them. Our goal is to better understand how others are handling other procedures rendered in conjunction with PRP injections that are not specifically called out as being included in the 0232T code.
 
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Hi there, to clarify - are you asking if the procedure (eg a tenotomy) can be billed when the provider injects platelet rich plasma?
 
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mireyitadauto said:
Some of our physicians are performing tendon fenestrations, tenotomies, and patellar fat pad hydro dissections when performing PRP injections. Our physician believes these services are included in the PRP injection and not separately coded/billed. There is no guidance from the AMA/AHA or other reliable resource that can help support or refute this. Being that this is a cash item, how are you treating the other procedures when performed in conjunction with PRP's?
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I've attached an AAOS resource that discusses PRP injections should be performed in a complete separate patient encounter from a surgical procedure and is not separately billable. I hope this helps :)
 

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