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PRP Injections, knee, hip, foot

  1. #1
    Default PRP Injections, knee, hip, foot
    Clearnace Sale
    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

  2. #2
    Location
    lawrence, kansas
    Posts
    54
    Default
    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 by RyanRaichCPC; 10-12-2018 at 03:40 PM.
    Ryan Raich, CPC COSC
    Lawrence, Kansas Chapter President

  3. #3
    Location
    Bradenton/Sarasota
    Posts
    7
    Default
    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

  4. #4
    Question 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 ?

  5. #5
    Default
    Quote Originally Posted by bharathiT View Post
    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 ?
    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.
    Set_Apart CPC, CEMC, CGSC
    Colossians 3:23

  6. #6
    Question 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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