Wiki Help! Need coding advice for PRP use in OR setting

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sblesnuk

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Hello,

I need some direction for the coding for both the professional and ASC side.

Our Orthopedic surgeons are using the Arthrex ACP system in a surgical setting. What is actually being done is...the blood is drawn from the patient, spun in a centrifuge, and the platlet-rich-plasma (PRP) is being either injected into a joint or mixed with a bone graft and then put in the operative site.

I need advice as far as what the surgeon can bill for as well as what the ambulatory surgery center can bill for, and if anyone is being reimbursed for it. We are trying to see if we can off set the cost of the supplies needed to do so.

Thanks,
Debbie
 
Debbie,

A former coworker sent me this from CPT Assistant, as I recently had a similar situation. It may answer your specific question(s).

June 2007 CPT Asst pge 10... Surgery: Hemic and Lymphatic Systems

Question:

Is it appropriate to report separately bone marrow that is aspirated
for grafting in an arthrodesis procedure?

Answer:

If bone marrow is aspirated for grafting in an arthrodesis procedure,
code 38220, Bone marrow; aspiration only, is used to report the separate
aspiration procedure. However, when the bone marrow is obtained prior to
the arthrodesis, the placement of the bone marrow aspirate is included
as part of the arthrodesis procedure and not reported separately.
 
Debbie,
We have had no luck getting paid for the injections when they are done
independently and have spoken with other offices that have had the same
problem.
 
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