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Thread: stem cell and or prp treatment

  1. #1

    Question stem cell and or prp treatment

    AAPC: Back to School
    Hello all, I work for a pain mgmt/anest doc looking to invest in a stem cell machine (centrifuge?) and I am trying to find out reimbursement and codes for these procedures he will primarilly be doing this on the spine any help will be appreciated thanks

  2. #2
    Join Date
    Apr 2007
    Charleston, South Carolina


    You should look at 0232T, and know what it includes and excludes. It was effective 7/1/10. It has no RVUs and therefore no monetary value for Medicare. Commercial carriers may cover it, but payment may be based on your contract negotiations. There are a good number of coverage polices by carriers that are not covering it. It is also important to remember that it may be considered incidental to other procedures.

    0232T (injection[s], platelet rich plasma, any tissue, including image guidance, harvesting and preparation when performed). However, CPT instructs not to report 0232T in conjunction with 20550, 20551, 20926, 76942, 77002, 77012, 77021 and 86965.

    The following components are included in the PRP and cannot be billed separately.
    20550-20551 - tendon and tendon sheath injection
    20926 - tissue graft
    76942, 77002, 77012, 77021 - imaging
    86965 - pooling of platelets or other blood products
    Machelle Morningstar, CPC, COC, CEMC, COSC
    AHIMA Approved ICD-10-CM/PCS Trainer

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