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Cristina Bentin, CCS-P, CPC-H, CMA, is principal of Coding Compliance Management.
Q: Is it appropriate to report Category III code 0232T, (injection[s], platelet rich plasma, any tissue, including image guidance, harvesting and preparation when performed) when performed during an orthopedic procedure and the injection/placement is into the operative site?
Cristina Bentin: No. The placement/injection of the cells into the operative site is an inclusive component of the operative procedure performed and not separately reported. Category III code 0232T can only be reported if the PRP injection is performed on a nonsurgical site or when performed unrelated to the surgical site. CPT instructs not to report Category III code 0232T in conjunction with 20550, 20551, 20926, 76942, 77002, 77012, 77021 and 86965.
Cristina Bentin can be reached at cristina@ccmpro.com. Learn more about Coding Compliance Management.
The information provided should be utilized for educational purposes only. Please consult with your billing and coding expert. Facilities are ultimately responsible for verifying the reporting policies of individual commercial and MAC/FI carriers prior to claim submissions.