DecisionHealth, DecisionHealth - 2022 Issue 11 (November)

Don’t split bill a PRP procedure to get paid for injection using different codes

Question: One of our physicians has begun performing platelet-rich plasma (PRP) injections. Under this treatment scenario, someone from an outside facility collects and prepares the PRP, then our doctor injects it. The patient pays a self-pay portion to the outside facility for the collection, and we bill the injection code to insurance (20610, 20551). This does not seem correct to me. I feel we should be collecting payment from the patient, having them sign ABN, and billing 0232T to insurance with an appropriate fee to reflect just injecting PRP or harvesting and injecting PRP. Could you please confirm whether we can split out and bill the injection portion to insurance using 20610?

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