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autologous blood injection

Renee Posted Tue 07th of March, 2017 13:34:15 PM
we have a foot & ankle specialist who has joined our ortho practice and wants to perform these autologous blood injections for plantar fasciitis. can you help with with coding for this? is it still only reportable with an unlisted code? I have read other sources that indicate it could be billed out under 20550 - any clarification would be most appreciated
SuperCoder Answered Wed 08th of March, 2017 01:37:55 AM

Autologous Blood Injection also known as Autologous Conditioned Plasma (ACP) Injection is most commonly used to treat degeneration of tendons, which may occur in association with small tears. The injection of blood contains small cells called platelets, which contain platelet derived growth factor. This substance is thought to promote tendon healing. A variation on the technique is Platelet Rich Plasma (PRP). SO, if the PRP injection was performed, you need to use CPT Code 0232T. Most of the insurance companies do not cover the Autologous Blood Injection and Platelet-Rich Plasma (PRP) injection experimental and investigational for Plantar fascitis.

Also, do not report 0232T in conjunction with 20550, 20551, 20600-20610, 20926, 76942, 77002, 77012, 77021, 86965.

Renee Posted Wed 08th of March, 2017 08:38:54 AM
that doesn't really address my question ~ I understand WHAT it is and this is not the PRP injection, and I understand that most insurances won't cover, but we are wondering if the 20550 is in any way appropriate billing for this procedure, or do we use an unlisted code. thanks for clarifying ~
SuperCoder Answered Thu 09th of March, 2017 02:32:43 AM

There is very less information available for autologous blood injection. Some payer allows CPT code 20550 for this procedure and some ask for unlisted CPT code. Also, most of the insurance companies considered it as experimental and investigational for Plantar fascitis. So we would request you to check it with your respective Insurance company medical policies and documentation like what they are allowing for it.

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