PRP injection only

My doctor is doing PRP injections only; the surgery center is doing the harvesting, prep, and image guidance, so I don't think we can bill using 0232T. No other procedures are being performed. Should I bill using 20610 (it was in the knee joint)? Or maybe unlisted in case the insurance doesn't cover PRP injections?



  • edited May 2017
    Anyone know the answer to this?
  • edited May 2017
    PRP is not covered by any insurance I know of, no matter if it's global or not. I would decide on a price for the surgeon, have the patient sign an ABN, and make it self pay. Don't bill insurance at all. To keep it straight in your records I would bill the 0232T with a 26 modifier, just so you know what it was, but don't send it to insurance. I would advise the surgery center to do the same with a TC modifier. We do these in our office and the company with the equipment to spin down the blood comes to us, but it's all self pay. I haven't heard that the rules on this have changed. Has anyone else?
Sign In or Register to comment.