Wiki PRP injection

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spebuck

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We've been using 0232T for PRP injections and not getting paid by insurance companies(for the most part). We get the money up front from the patients.
I just heard that another office is using P9020 because it gets paid for. I thought a "P" code was a pathology code & that P9020 would not be appropriate coding for the PRP injection.
Did I miss a news bulletin?
 
Prp

The correct code is:
0232T (injection, platelet rich plasma, any tissue, including image guidance, harvesting and preparation when performed)
you may not bill with anything else as all in included. P9020 is a path/lab service and is not appropriate to code for PRP injection. As for reimbursement, there are no insurance companies in our area that will pay as it is considered experimental and investigational. Everyone that I know of that is doing this is collecting payment prior to service and having patient sign waiver that they understand this is not covered by insurance.
 
KMCFADYEN said:
The correct code is:
0232T (injection, platelet rich plasma, any tissue, including image guidance, harvesting and preparation when performed)
you may not bill with anything else as all in included. P9020 is a path/lab service and is not appropriate to code for PRP injection. As for reimbursement, there are no insurance companies in our area that will pay as it is considered experimental and investigational. Everyone that I know of that is doing this is collecting payment prior to service and having patient sign waiver that they understand this is not covered by insurance.
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0232T is what i use too!
 
paulebenezer1209@gmail.com said:
In a case if patient treated with two Vials of platelet how should we append code?
Should we code 0232T once and P9020 twice. Is that correct?
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These codes are used for two separate things- do not bill them together. Bill only the appropriate code for what was performed.

Reference: https://www.cms.gov/medicare-covera...de=P9020&hcpcsEndCode=P9020&sortBy=title&bc=1

0232T is the HCPCS code representing platelet rich plasma injection, any site.

It is Noridian's expectation that the HCPCS code P9020 (platelet rich plasma, each unit) be billed for one or more units of PRP transfused in the treatment of the conditions/coagulopathies for which it is indicated. This code MUST NOT be used to describe the injection of PRP into a specific site.
 
iowagirl77 said:
These codes are used for two separate things- do not bill them together. Bill only the appropriate code for what was performed.

Reference: https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58790&ver=13&keyword=&keywordType=starts&areaId=all&docType=6,3,5,1,F,P&contractOption=all&hcpcsOption=code&hcpcsStartCode=P9020&hcpcsEndCode=P9020&sortBy=title&bc=1

0232T is the HCPCS code representing platelet rich plasma injection, any site.

It is Noridian's expectation that the HCPCS code P9020 (platelet rich plasma, each unit) be billed for one or more units of PRP transfused in the treatment of the conditions/coagulopathies for which it is indicated. This code MUST NOT be used to describe the injection of PRP into a specific site.
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Thank you for the response, But still i do want know when we can use the code P9020 code. For facility side can we use the code P9020?"
 
We bill P9020; however, most insurance companies are still denying as experimental. We do get patient payment if they wish to pursue.
 
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