Forum - Questions & Answers

May 6th, 2009 - Alexand945

Plasma rich platelet injections

For practices are doing plasma rich platelet injections (PRP), what codes are you using?

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May 6th, 2009 - nmaguire   2,606 

Prp

CPT® Assistant November 2005 Volume 15 issue 11
"Question: During an orthopedic procedure, 60 cc of the patient’s blood was drawn and then centrifuged for 15 minutes to separate the PLATELET-rich PLASMA from the PLATELET-poor PLASMA. The red cells were injected into the operative site. What are the appropriate CPT codes to report for these procedures?

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."

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Mar 9th, 2010 - luannw7     18 

Is this still current?

[CPT® Assistant November 2005 Volume 15 issue 11
"Question: During an orthopedic procedure, 60 cc of the patient’s blood was drawn and then centrifuged for 15 minutes to separate the PLATELET-rich PLASMA from the PLATELET-poor PLASMA. The red cells were injected into the operative site. What are the appropriate CPT codes to report for these procedures?

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."
]

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Mar 18th, 2010 - nmaguire   2,606 

PRP 2010, July Category III

New Category III codes for orthopedic procedures and pain management injections start July 1
Category III codes are a temporary set of codes for emerging technologies, procedures and services that are released on a semi-annual basis and effective six months later. Here are two newly released Category III codes that will take effect on July 1.

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.

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Aug 10th, 2010 - jschmutz   323 

Plasma Rich Protein (PRP) and Platelet-Derived Growth Factor (PDGF) Injections (0232T)

Plasma Rich Protein (PRP) and Platelet-Derived Growth Factor (PDGF) Injections:

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.

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