• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Prolotherapy

M

MDPAYNE

Contributor
Messages
18
Location
Idaho Falls, ID
Our dr. Has a couple of patients that have asked him to do prolotherapy injections on them. Does anyone know of a code to us and if the insurance carriers are paying for this type of a procedure?
 
M0076 prolotherapy is a HCPCS code that could possibly be used. The commercial carriers should have medical policy on the coverage for this and if this is the HCPCS code they recognize> I did not look to see the ratio of carriers that recognize payment versus ones that do not.

Below is from NCD from Medicare stating it is non covered

Indications and Limitations of Coverage

The medical effectiveness of the above therapies has not been verified by scientifically controlled studies. Accordingly, reimbursement for these modalities should be denied on the ground that they are not reasonable and necessary as required by §1862(a)(1) of the Act.
 
You must log in or register to reply here.
Top