rrussell
New
One of my providers is going to start offering PRP Injections (platelet rich plasma). I understand that there is a Category II code, 0232T, that represents the injection, image guidance, harvesting and prep of the plasma. I also understand that most carriers deem this procedure as experimental.
I understand that most practices bill the patient for a set fee that covers everything depicted in the T code, due to the fact that insurance most likely will not cover.
My question is, has anyone tried billing a joint injection (20600-20610), the 76942 for the ultrasound guidance, and then a lesser amount to the patient for the prep and harvest of the PRP kit? I want to try to minimize the out of pocket cost to patients as much as possible, wasn't sure if anyone had tried this yet.
Next part of this, I have checked with some of my payer reps. UHC has said that some plans do cover PRP and they will allow $63 for 0232T. That doesn't come clost to covering the cost of the kit. Do I have to bill that code and accept the $63 as payment in full if the patient has the benefits? I'm losing money if I do.
Any thoughts or advice is greatly appreciated!
I understand that most practices bill the patient for a set fee that covers everything depicted in the T code, due to the fact that insurance most likely will not cover.
My question is, has anyone tried billing a joint injection (20600-20610), the 76942 for the ultrasound guidance, and then a lesser amount to the patient for the prep and harvest of the PRP kit? I want to try to minimize the out of pocket cost to patients as much as possible, wasn't sure if anyone had tried this yet.
Next part of this, I have checked with some of my payer reps. UHC has said that some plans do cover PRP and they will allow $63 for 0232T. That doesn't come clost to covering the cost of the kit. Do I have to bill that code and accept the $63 as payment in full if the patient has the benefits? I'm losing money if I do.
Any thoughts or advice is greatly appreciated!