Question PRP injections where Provider is only doing the injection portion?

Kaidachi

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I have a provider that just started doing PRP injections in clinic and the machine and kits are supplied by a vendor.
From the information I gathered from the clinic manager, the patient pays the vendor upfront for the treatment. The vendor company is then doing all the harvesting and processing of the blood. The provider I am coding for is only injecting the PRP into the joint.

My questions are:

The provider is wanting to code this encounter as a 20610 because they are only doing the injection.
I"m not sure that we can code anything as the vendor company is charging the patient with 0232T.
What is the correct coding or how should this be handled?


I tried searching on the forum but I didn't see a thread quite like the provider just sticking the patient and not doing any of the other parts of the procedure.
Thanks for your help!!!
 

Kaidachi

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For whatever reason, the vendor skirted the Clinic Manager and went straight to the Physician with this. So apparently the patient already paid the vendor. I originally told the manager that we can't bill the way he did it. The 0232T is all inclusive........ if they continue to do this then the vendor should be paying our physician to do the injection parts?
 
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Yes they should, The doctor is taking the risk and he needs to be compensated for his part. We do As the previous answer, We charge for the 0232T and then pay the vendors for their part. We have been doing this for several years and it works out great.
 

sxcoder1

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When I was working in ortho, we had the same situation, however we did the billing and billed the 0232T. The patient paid us and then we paid the vendor.
 
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