Wiki BMAC Reimbursement for stem cell kit

[TJAlexander]

Our MD provides regenerative therapy treatments (BMAC, PRP, Stem Cell, Lipogems) to patients as a self-pay service. However, after getting confirmation from BCBS, we were advised that we can submit a claim for these services using 38206 and 20610. The only problem is that the allowed amount for these services is very low. The kit alone costs $1300. Is anyone billing insurance carriers for this service and if so, how are you billing for the cost of the kit?

 

[lexvcarter]

Hmm very good question. Let me research this & I’ll get back to you.

 

[TJAlexander]

Hmm very good question. Let me research this & I’ll get back to you.

Thanks! All the information I've found so far indicates C1713 but we can't bill that code because the procedure will be done in an office. We also cannot bill 99070. Are we allowed to have the patient sign a waiver regarding the cost of the kit?

 

[lexvcarter]

Do you know what comes in the kit and what company you bought it from?

 

[TJAlexander]

We use Arthrex. I'm not sure what all comes in the kit but I downloaded a waiver from the patient's insurance carrier for the patient to sign. Performing this service in an office doesn't allow for appropriate compensation from insurance in my opinion.