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Wiki PRP Injections, knee, hip, foot

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Denise M

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Flemington, NJ
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What codes are appropriate for ASC?

We were using 20926 and either 20550 or 20551, the most recent info states not to use 20926.

I believe it should be billed as a single injection for PRP including injection. What code is best for ASC?

Thank you in advance,

Dee
 
Hello,

0232T should be used for PRP injections. 20926 is a stretch for considering PRP a graft and may be incorrect coding. I understand a reimbursement is always wanted, however, this procedure is experimental in nature. We perform them on a routine basis in office and normally require upfront payment for this particular service.
 
Last edited:
Hello,

Can this be billed to the patient even if there is another procedure being done at the same time at an ASC? I work at an ASC and the big question right now is if the patient is coming in for an already scheduled procedure and the surgeon wants to do a PRP injection can we bill the patient for the PRP injection or is it considered inclusive?

Thank you:o
 
0232T with 20610/20605/20600

Can we code PRP injections with Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance as combined ?
 
bharathiT said:
Can we code PRP injections with Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance as combined ?
Click to expand...

Currently, there is a CCI edit between CPT 20610 (column 1) and CPT 0232T (column 2). If the PRP injection was performed at the same site as the joint arthrocentesis, aspiration or injection then I would only bill for CPT 20610. If the PRP injection is at a completely different site then I would bill the PRP injection with a modifier 59.
 
0232T in facilities vs non- facilities?

PRP INJECTION (0232T) used in both facilities and non -facilities setting ?

Any guidelines regarding usage of 0232T in NON -facilities or Facilities coding ?
 
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