January 4, 2018
Our physicians are asking us to report 38220 and 0232T when they harvest bone marrow aspirate from the iliac crest for platelet rich plasma and inject it during another procedure. Is this correct? If not, can we report 0232T? What if the only service performed is a PRP injection using bone marrow aspirate?
You’ve asked two questions, so we’ve provided two parts to our answer:
CPT Category III code 0232T was introduced in 2010 for reporting injection of platelet rich plasma to a targeted site; the code definition includes all harvesting, preparation, and image guidance for the service. In August 2010 the AAOS published guidance in AAOSNow which explained “The new code is to be used only when PRP is performed in a complete separate patient encounter from a surgical procedure.”
Based on this direction, when PRP is injected during another procedure, whether using drawn blood or bone marrow aspirate, it is not separately reportable with the primary surgical service.
If PRP injection is the only service performed, then 0232T is the correct code. In recent years some physicians have begun using bone marrow aspirate harvested from the iliac crest instead of drawn blood for PRP preparation, and reporting the harvesting using CPT code 38220. The May 2012 edition of CPTAssistant clarified that 0232T is the only code reportable for PRP injection, whether performed using drawn blood or harvested bone marrow aspirate. In 2018 the definition of 38220 was changed to reflect that it should be used only for diagnostic bone marrow aspiration. New code 20939 should be used when bone marrow aspiration is performed for bone grafting, for spine surgery only, via a separate incision.
*This response is based on the best information available as of 01/04/18.