# CPT for bone marrow aspiration and injection for meniscus repair ??



## Orthocoderpgu (Jan 20, 2016)

Physiian repaired the meniscus. After that, he aspirated some bone morrow and injected into the meniscus repair. I have never seen that done before. Is there a code for this procedure? Is it separately reported or part of the meniscus repair? Any ideas ???


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## shecodes (Feb 2, 2016)

The  correct code is 0232T, though most payers deem this experimental and it will not get paid. This is where ABN's come in handy.


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## sxcoder1 (Feb 2, 2016)

0232T is for platelet rich plasma injection. What about 20926, tissue graft, other.


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## shecodes (Feb 4, 2016)

Direction underneath 0232T states (Do not report 38220-38230 for bone marrow aspiration for platelet rich stem cell injection. For bone marrow aspiration for platelet rich stem cell injection, use 0232T) .

This process involves bone marrow aspirate being spun down to concentrate the stem cells to assist in healing. This concentrate includes prp as well as the stem cells.

There is also a *CPT Assistant, May 2012* that discusses this.

Coding Brief 

Bone Marrow Aspiration/Injection of Platelet/Stem Cells (0232T) 

Category III code 0232T, Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed, was implemented effective July 1, 2010. Since implementation of code 0232T we have received questions related to the use of code 0232T when platelet rich stem cells are derived by bone marrow aspiration as opposed to venous blood collection. 

Example: What code(s) should be reported for the purpose of deriving and injecting platelet rich stem cells from bone marrow aspirate for a patient with a diagnosis of nonunion of tibia fracture? Using a core needle and trocar, bone marrow aspiration into a 60-cc syringe was performed. Via a separate trocar insertion site, 35 cc of bloody aspirate was obtained, and the aspirate was prepared to obtain the platelet rich cells (ie, hematopoietic stem cells and mesenchymal stem cells). Next, the plate and screws were removed from the tibia. The platelet stem cells were then injected through a small stab incision into the tibial nonunion site. 

In this example, CPT Category III code 0232T should be reported for the injection into the operative site of the platelet rich plasma containing the stem cells. The harvest of bone marrow and bloody aspirate from the right iliac crest into a 60-cc syringe is considered inherent in code 0232T. Code 0232T is reported in addition to the definitive tibial fracture nonunion repair code (27724). Since CPT coding guidelines may, however, differ from third-party payer guidelines, eligibility for payment, as well as coverage policy, is determined by each individual insurer or third-party payer. For reimbursement or third-party payer policy issues, please contact your local third-party payer. 

Category III code 0232T involves collection of the specimen (either by venous blood collection or bone marrow aspiration), which is then spun down and the platelet rich plasma that is collected is injected into the operative site. Code 0232T also includes any imaging guidance used for harvesting and the preparation for injection. Therefore, it is not appropriate to report code 86999, Unlisted transfusion medicine procedure, for obtaining and centrifuging the blood drawn or to report code 86985, Splitting of blood or blood products, each unit, to describe the derivation of the platelets. In addition, none of the codes specific to aspiration or harvesting of bone marrow (eg, 38220, 38230, etc.) would be appropriate to report when the procedure is being performed to obtain platelet rich plasma.


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## sxcoder1 (Feb 4, 2016)

Oh, I didn't see that!


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## Maylin819 (Jan 20, 2017)

What about bone marrow aspiration cpt code: 38220. Would that be covered with surgery?


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## shecodes (Jan 20, 2017)

As stated in the CPT Assistant



> In addition, none of the codes specific to aspiration or harvesting of bone marrow (eg, 38220, 38230, etc.) would be appropriate to report when the procedure is being performed to obtain platelet rich plasma.


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