AMA Comment: The instillation of the PLATELETs by the surgeon into the surgical site would not warrant additional CPT code reporting as this is considered an integral part of the total procedure performed; therefore, the instillation is not separately reportable as there is no significant, additional physician work involved. However, code 86999, Unlisted transfusion medicine procedure, should be reported when blood is drawn intraoperatively from the patient and centrifuged to separate the PLATELET-rich from PLATELET-poor PLASMA and the red cells are injected into the operative site."

AMA Comment: The instillation of the PLATELETs by the surgeon into the surgical site would not warrant additional CPT code reporting as this is considered an integral part of the total procedure performed; therefore, the instillation is not separately reportable as there is no significant, additional physician work involved. However, code 86999, Unlisted transfusion medicine procedure, should be reported when blood is drawn intraoperatively from the patient and centrifuged to separate the PLATELET-rich from PLATELET-poor PLASMA and the red cells are injected into the operative site." ]

Platelet rich plasma injections. PRP injections involve collecting a patient’s blood, separating out the platelet rich portion, containing the growth factors and injecting it back into the injury site, should be reported as 0232T (injection[s], platelet rich plasma, any tissue, including image guidance, harvesting and preparation when performed). However, CPT instructs not to report 0232T in conjunction with 20550, 20551, 20926, 76942, 77002, 77012, 77021 and 86965.

The following components are included in the PRP and cannot be billed separately. 20550-20551 - tendon and tendon sheath injection 20926 - tissue graft 76942, 77002, 77012, 77021 - imaging 86965 - pooling of platelets or other blood products

When implemented, it is important to verify with your Medicare and commercial carriers as to individual reporting and reimbursement policies for the PRP procedure.

Based on the previous post the new category III code 0232T (injection[s], platelet rich plasma, any tissue, including image guidance, harvesting and preparation when performed) involves collecting a patient’s blood, separating out the platelet rich portion, containing the growth factors and injecting it back into the injury site.

What should be reported when the physician is not collecting the blood or separating out the PRP portion? What if a vendor or hospital tech is obtaining the blood and separating it and the physician is just injecting?

The scenario that I most often see is the following: Patient is brought to the OR and the anesthesiologist or hospital tech collects the patient's blood and then the vendor rep prepares the blood by centrifuging it. The physician then comes into the operating room and injects the PRP. (This is done in a hospital as an outpatient procedure. It is the only procedure being performed.)

Thanks.