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0232t injected into 2 sites

K Posted Wed 06th of November, 2019 12:19:15 PM
The doctor took the blood from the patient's arm, centrifuged it and injected it into the C5-6, and C6-7 facet joints. Then injected an additional amount into the abductor pollicis brevis. Would this be considered one 0232T or two since it is only centrifuged once but injected into 2 separate sites? Thank you.
SuperCoder Answered Thu 07th of November, 2019 03:22:16 AM

Hi K,

 

MUE (Medicare Unlikely Edits) for CPT code 0232T is 1 which means this code can be biled  for 1 unit for a date of service, however MAI is 3 for this code which suggests MACs may pay excess units upon appeal or may bypass the MUE based on documentation of medical necessity. If your documentation can support the medical necessity and justify the need for billing this code for more than 1 units, you can bill this code for more than 1 units. 

 

You need to check with your payer as well regarding the guidelines related to billing this code for more than 1 units. Most of the payers still do not pay this code as they consider this service as investigational.

 

Thank you! 

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