Wiki Regenerative Medicine - PRP/Allograft

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carolynmarieivy

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Hello All,

Thanks in advance for any feedback!

I am wondering what your experience has been regarding whether or not it is appropriate to charge a patient for regenerative medicine, eg: PRP, allograft while charging the insurance for the procedure which is typically a facet injection.

I need to know what the legality around this is and what anyone else might be doing in this scenario.

Thank you!
 
Thanks for the reply!

I should be more specific,...

Example: One of my physicians are doing a cervical facet injection. While doing that he also injects allograft at the same time. 99.9% of commercial payers do not cover those services (allograft) so would it be considered fraud if I am not reporting the allograft? Should I be billing the allograft also? If I do, then will the facet injection be denied also?!

I know this is somewhat confusing and I am having a hard time getting a straight answer.

Thanks again!
 
Allograft with injection

Carol,

The doctor is injecting allograft or PRP?

Alexandra
 
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