Can someone help me with this coding scenario? Physcian office bills cpt 20926 for these. According to CPT book it states for injection of platelet rich plasma to use 0232T. If it is a Medicare patient, they only pay $18.55. Not worth doing in the ASC if that is the case. Also how does commercial insurance companies pay for these?
I appreciate any info.
PREOPERATIVE DIAGNOSIS: Chronic plantar fasciitis, right foot.
POSTOPERATIVE DIAGNOSIS: Chronic plantar fasciitis, right foot.
PROCEDURE: PRP injection, right foot.
PROCEDURE IN DETAIL: The patient was brought to the preoperative holding area where IV access was initiated. The procedure was once again explained in detail to the patient and she voiced no concerns. Her history and physical were reviewed and no changes had been made since her previous visit. The patient was then transported to the operating room and left on the stretcher. Approximately 24-30 mL of the patient’s blood was drawn and prepared according to PRP guidelines. Mild MAC anesthesia was initiated and an ankle block was performed about the right ankle utilizing 20 mL of 0.5% Marcaine plain. Once adequate anesthesia was obtained, 4 mL of prepared PRP was injected into the plantar aspect of the right heel in a fanned fashion at the point of maximum tenderness, which was palpated and marked prior to the initiation of anesthesia.
The foot was cleansed after a prep was performed utilizing Betadine. A band-aid was applied. The patient was then transferred to the recovery room with vital signs stable and vascular status intact. She tolerated the injection well. She was given all home-going instructions as well as Tramadol for pain management. A postoperative shoe and crutches were also given to the patient. She will follow up in my office in Corbin within two weeks.
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