Wiki PRP INJECTIONS

[cwilson3333]

Patient have Debridement and Repair of Achilles Tendon, outpatient surgery
Will also have PRP injection

I don't think the insurances pay for PRP, but can I charge for the Physician Injection [20605] during the main surgical procedure.
In-house, the patient is charged for the PRP kit and procedure.

Thanks

 

[thomas7331]

No, the code for the injection procedure for PRP is 0232T - that's what you should use if you were to bill it. It would be incorrect coding to use 20605.

 

[kimberlywatson]

Agree with the above answer. The 0232T includes the administration and imaging guidance.

 

[mccoyheather]

PRP- 0232T - Provider is questioning why such a low reimbursement as "all components are included" = time and prep, blood draw with supplies (supply tubes are expensive), harvesting, guidance, and injection. Local MAC FCSO FL 99 allowed is $215.58 single unit. Billing: Multiple joints on same date of services for example hip, shoulder, knee billed 0232t x 3 units or separate line items per single unit and applicable DX? Modifiers RT/LT/50 are not applicable. Vendors have not been forthcoming with billing information. I am wondiering if any other providers have concerns about the very low payer payment rates. All feedback welcomed! thanx!