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Platlet rich gel injection.

  1. #1
    Location
    Greater Pittsburgh
    Posts
    390
    Default Platlet rich gel injection.
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    One of my Drs is taking the patient to the OR to inject platlet rich gel into the Achilles Tendon.....does anyone have any knowledge of this procedure??? :
    jdemar, CPC, CMA

  2. Arrow Platelet rich gel injection
    See this guideline:


    “If physician draws patient's blood intraoperatively, uses special equipment in the OR to centrifuge into separate elements, isolation of the required component (red cells or platelets), and finally injecting the desired component into the operative site. With all this being well documented in a report, this would be captured with CPT code 86999*.”

    I have been coding these procedures for quite a long time now .

    Thank You
    Amit Joshi MSc,CPC,CPC-H

  3. #3
    Location
    Greater Pittsburgh
    Posts
    390
    Default
    Thank you both for your help, I am checking w my Dr. to see if the 86999 is correct, not sure if he is spinning the blood in the OR or the blood bank @ the hospital is taking care of that portion....thanks again
    jdemar, CPC, CMA

  4. Default
    Can I use 20926 for the Autologous platelet gel injection? Medicare is paying for it. Thanks
    Madelin

  5. #5
    Location
    South Bend
    Posts
    23
    Wink
    20926 is the code that we use and we have been doing this for over a year. We are using the GPS from Biomet? Is this the same product you are using?

  6. Default
    The code I was told to use by the rep is
    36513: therapeutic apheresis;for platelets.

    Apheresis: Medicine/Medical. the withdrawal of whole blood from the body, separation of one or more components, and return by transfusion of remaining blood to the donor

    Mollie

  7. #7
    Location
    ENGLEWOOD/DENVER
    Posts
    2,338
    Default
    Quote Originally Posted by amitjoshi4 View Post
    See this guideline:


    “If physician draws patient's blood intraoperatively, uses special equipment in the OR to centrifuge into separate elements, isolation of the required component (red cells or platelets), and finally injecting the desired component into the operative site. With all this being well documented in a report, this would be captured with CPT code 86999*.”

    I have been coding these procedures for quite a long time now .

    Thank You

    Where did this guideline come from?

  8. Arrow
    Hi,

    This is the Q&A published in CPT Assistant "November 2005, Volume 15,Issue 11,Page 14"

    Hope this benefits all.

    Thank You
    Amit Joshi MSc,CPC,CPC-H

  9. #9
    Location
    ENGLEWOOD/DENVER
    Posts
    2,338
    Default
    Since that CPT asst is from 2005, I think I will stick with Mollie. I also use the 36513. The lay description (which I have posted below) better describes what is performed.


    36513
    Therapeutic apheresis is the removal of some specific circulating blood component, cells or plasma solute, that is directly responsible for a disease process. Cells and plasma components may also be mobilized from other tissue storage during apheresis, such the from the spleen and lymph nodes, for enhanced clearance of the undesired element. The patient is prepared much the same as giving a regular blood donation. Whole blood is drawn out of one arm and into an instrument called a separator, which uses a microprocessing technique to draw the blood, anticoagulate it, and separate the component to be removed by centrifugal spinning, filtration, or column adsorption with the help of computerized calibration. The cells to be removed are collected while the remainder of the blood is recombined and returned to the patient through a tube and needle in the other arm. Report 36511 for white blood cell isolation and removal (leukapheresis or lymphocytapheresis), 36512 for red blood cell removal, and 36513 for removal of platelets.

  10. #10
    Default Platelet rich gel injection
    We also are doing the GPS, and have been billing for the injection(20550) and the graft(20926). However, in the April 2008 Ortho Pink Sheet it states that "there is no appropriate physician code to report". You may report 86999 if "you own or lease you own laboratory". I also listened to a audio conference on 6/10/08 given by Destiny Health( Margie Vaught) who states you can bill for the injection with a modifier 22 for the extra work. Hope this helps!

    Judy

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