Wiki Plasma Rich Platelet Therapies

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Does anyone have any experience billing for Plasma injections? Would code 89999, unlisted transfusion medicine procedure along with the appropriate injection code be correct? Any guidence on this subject would be greatly appreciated.

Vicki
 
When we used the Harvest system for plasma enriched platelets we used CPT 20926 Tissue grafts, other (eg, palmaris, fat, dermis). This was given by the Harvest rep but has survived insurance audits.
 
Vicki

Our Surgery Center has been doing this PRP injections for a while now. I have been billing the 20926 code that the reps provided ( for lack of another payable cpt code.) Recently I have started receiving denials from Premera Blue Cross for this cpt code - and they are our biggest payor! Since the cost of the kit for the prp is not cheep, I am now looking at billing as a supply charge and summiting the invoice to show the expense involved. This is how I originally billed and it worked.

I've read the article written by Marie Vaught and it is very informative. I agree that the 8000 code is probably the best cpt fit, but unfortunately it is not payable if you are a ASC. If your are billing for the physician side you will probably have better luck. Either way check your contracts to see which codes are payable and then bill which ever one will get you paid.

Leslie
CPC
 
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