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PRP cat III code 0232T help please!!!

  1. #1
    Exclamation PRP cat III code 0232T help please!!!
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    I am not familiar with Cat III codes, if you don't use it you lose it!
    I have a Dr that is doing the PRP procedure/platelet rich plasma injection.
    Would I use a CPT code in leu of the 0232T since per what I've been reading the 0232T code is not FDA approved.
    Any help would be greatly appreciated.

    thank you,
    Susan

  2. Default
    I went to a workshop on 3/10/11 put on by Mary Legrand, Karen Zupko and associates, inc.
    In the booklet that was given it says for 2011 CPT code update: PRP
    use (0232T) and that is for everything so it should NOT be reported in addition to CPT codes 20550, 20551, 20600-20619, 20926, 76942, 77002, 77012, 77021, 86965.

    It also states since all the work is included in that one code set the fee high to include all that work.... BUT, payers don't like to pay for this code so let the patient know they will most likely be responsible.

    Hope that helps.

  3. #3
    Location
    Long Island/New York
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    1,271
    Default
    Quote Originally Posted by sgormsen View Post
    I am not familiar with Cat III codes, if you don't use it you lose it!
    I have a Dr that is doing the PRP procedure/platelet rich plasma injection.
    Would I use a CPT code in leu of the 0232T since per what I've been reading the 0232T code is not FDA approved.
    Any help would be greatly appreciated.

    thank you,
    Susan
    We collect payment up-front...

  4. #4
    Default PRP injections
    Since the 0232T is not reimbursed by most payers, can you code an EM along with it?

  5. #5
    Location
    Columbia, MO
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    no you cannot if the purpose of the encounter was for the injection.

    Debra A. Mitchell, MSPH, CPC-H

  6. Default Prp 0232t
    Quote Originally Posted by mitchellde View Post
    no you cannot if the purpose of the encounter was for the injection.
    PRP is FDA approved, However, payers still consider it experimental. You can find white papers on the web to support the use of PRP for the enhanced healing process especially in athletes.
    Be sure to get an ABN signed by the patient and inform them that insurance is not likely to pay. This procedure has proven science behind it and they should have the procedure even if they have to pay out of pocket. Most practices charge $250.00 to $450.00

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