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Prp injection with injection 20611

  1. Default Prp injection with injection 20611
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    I came across an account where the surgeon billed for a PRP injection and also for 20611 inj/aspiration but chart note does not indicate reason for 20611-injection. I was told by charge entry that provider bills for administering the prp injection and that 20611 is for the administration. Is there a code we can bill for administering a PRP injection? I know 20611 is not the correct code to use....??

  2. #2
    lawrence, kansas
    We routinely bill out PRP injections in the Orthopaedic practice in which I am employed. 0232T includes the administration of the injection, harvesting the PRP, and imaging guidance. Per the CPT book and CCI edits, 0232T should not be billed with CPT 20611. I would suggest clarifying with your provider if another distinct and separate injection was performed and if not just explaining that 0232T includes administration of the PRP. If you have further questions regarding the PRP or any other injection I would be happy to help!
    Last edited by RyanRaichCPC; 11-09-2018 at 01:17 PM.
    Ryan Raich, CPC COSC
    Lawrence, Kansas Chapter President

  3. Default Prp injections
    Our office bills the patient for the PRP kit. As far as we know the PRP [0232T] is still not an approved service?
    Can we bill the insurance for the injection [20610] or just an office visit?

    Thank you

  4. #4
    Quote Originally Posted by cwilson3333 View Post
    Our office bills the patient for the PRP kit. As far as we know the PRP [0232T] is still not an approved service?
    Can we bill the insurance for the injection [20610] or just an office visit?

    Thank you
    No. The code does not accurately describe the procedure being performed so would be a false claim. You cannot select a code that merely approximates the service performed. It defaults to the Category III code since one exists. There are category III codes that are covered just not this particular service.
    CRC (2018), CPC-P-A (2016), COC-A (2016), CPC-A (2015), PAHM (2010)
    Contract/Fee Specialist - Remote

    20 years health insurance experience: Audit, Claims, Customer Service, Payment Policy, Provider Relations, and Reimbursement

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