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Prp injections/ 0232t

  1. #1
    Question Prp injections/ 0232t
    Medical Coding Books
    Our office is having many discussions regarding PRP injections.
    I have read an AAOS document, dated 8/2010, that states that it should not be reported in conjunction with another procedure, however it does not come up as bundled when used with codes such as 29888(when I use our CCI edit program). In fact, the only codes that are specified as not billable w/PRP are 20550, 20551, 20600-20610,20926, 76942, 77002, 77012, 77021, 86965.
    At this point we are having the pt sign a waiver & pay up front as there is no insurance company that will pay for it.
    With the consensus out there being that it is to be billed seperately only, I am concerned that we are opening ourselves to legal problems when reported with surgical procedures, even tho we have the pt sign a waiver.
    Any thoughts or opinions?

  2. #2
    Location
    Long Island/New York
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    1,271
    Default
    Quote Originally Posted by spebuck View Post
    Our office is having many discussions regarding PRP injections.
    I have read an AAOS document, dated 8/2010, that states that it should not be reported in conjunction with another procedure, however it does not come up as bundled when used with codes such as 29888(when I use our CCI edit program). In fact, the only codes that are specified as not billable w/PRP are 20550, 20551, 20600-20610,20926, 76942, 77002, 77012, 77021, 86965.
    At this point we are having the pt sign a waiver & pay up front as there is no insurance company that will pay for it.
    With the consensus out there being that it is to be billed seperately only, I am concerned that we are opening ourselves to legal problems when reported with surgical procedures, even tho we have the pt sign a waiver.
    Any thoughts or opinions?
    You're not going to find the PRP in the edits. It can't be reported during a surgical procedure as it's considered part of the procedure itself (i.e 29881, 29827). We have patients sign a waiver and collect up-front. We charge aboyt $1,000 - we're based in NYC with higher overhead...but I've seen some charge $500. Insurance co's won't pay for PRP with a surgery so don't charge the patient...just for an injection. Hope this helps..

  3. Default
    I agree do not charge the patient. The 0232T is the correct surgical procedures code that should be charge.
    Diana Yates, CPC, CPC-H, CPC-I, CPEDS
    Past AAPCCA Board member 2008-2011

  4. #4
    Default
    What if multiple PRP injections are performed?
    PRP injection in Quadricpes for pain due to a strain, PRP injection into the medial meniscus for pain and PRP injection into the Knee for djd. Would you code 0232T once since this code includes harvesting and prep?

    Thanks in advance

  5. #5
    Default
    Joanne, did you ever get an answer on coding multiple injection sites?

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