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New Job, Please Help

  1. #1
    Post New Job, Please Help
    Medical Coding Books
    Hello.. PLEASE RESPOND if you can help.

    Our docs are doing Platelet Rich Plasma injections for epicondylitis, etc.. I know (from reading posts here) that there has been a Cat. III code for this (0232T) effective since July 2010 and that we've been advised to discontinue using the unlisted code for this. But I am left now wondering about three things:

    1. Are any of you currently getting paid for these injections now and if so, by which insurances? If denied, what kind of feedback have you gotten?

    2. How much are you charging for the code 0232T, and where/how did you come up with that fee?

    3. Does the code 0232T include the supply cost? Our Doc is buying the plasma kits and using them in our office. Shouldn't he be able to get reimbursement for the kits as well, and if so, what code do you suggest? (99070?)

    Thanks in advance for your help.
    Sheila Hardy, CPC-A CMBS

  2. #2
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    Long Island/New York
    Posts
    1,271
    Default
    Quote Originally Posted by ortholg@yahoo.com View Post
    Hello.. PLEASE RESPOND if you can help.

    Our docs are doing Platelet Rich Plasma injections for epicondylitis, etc.. I know (from reading posts here) that there has been a Cat. III code for this (0232T) effective since July 2010 and that we've been advised to discontinue using the unlisted code for this. But I am left now wondering about three things:

    1. Are any of you currently getting paid for these injections now and if so, by which insurances? If denied, what kind of feedback have you gotten?

    2. How much are you charging for the code 0232T, and where/how did you come up with that fee?

    3. Does the code 0232T include the supply cost? Our Doc is buying the plasma kits and using them in our office. Shouldn't he be able to get reimbursement for the kits as well, and if so, what code do you suggest? (99070?)

    Thanks in advance for your help.
    Sheila Hardy, CPC-A CMBS
    1. No insurance company is paying for the PRP.
    2. We charge up to $2,000. Some others charge $500-$1,000 depending on the physician preference. We are based in NYC (higher overhead). But we have the patients sign an ABN and get paid as a self-pay procedure.
    3. I believe the Category III codes includes all.

    Hope this helps. With so many docs doing this procedure I can't see how this won't get it's own category I codes as there is SO MUCH data out there now - especially well-known athletes.

  3. #3
    Default Thanks
    Thanks for taking the time to get back to me. I've been busy w/the new position which is why I haven't responded sooner. But I just wanted to take a min. to tell you we've decided to use the 0232T code and a 99070 for the kit. I based this on an article I found.. hm.. somewhere. So thanks for the feedback. Always appreciated.

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