Stem Cell Implant Knee Osteoarthritis

Stem Cell Implant Knee Osteoarthritis

September 19, 2019

Question:
Our surgeons are harvesting adipose tissue and creating an injectable implant that they are injecting in the knee for treatment of osteoarthritis. We want to verify that our use of an unlisted CPT code is correct. We have some payors who do reimburse for this service; others require the patient to be self-pay.

Answer:
Thanks for your question. You are correct in reporting an unlisted CPT code until the end of 2019. The AMA released new Category III codes on July 1, 2019 that will require the use of the new codes for tracking purposes as of January 1, 2020.

The new Category III codes effective January 1, 2020 are:

0565T
Autologous cellular implant derived from adipose tissue for the treatment of osteoarthritis of the knees; tissue harvesting and cellular implant creation
0566T (an indented code)
;injection of cellular implant into knee joint including ultrasound
guidance, unilateral

 

Parenthetical instructions include:
► (Do not report 0566T in conjunction with 20610, 20611, 76942, 77002)
► (For bilateral procedure, report 0566T with modifier 50)

These codes will be published in the 2020 AMA CPT Manual.

Please note:
These codes are for treatment of osteoarthritis of the knee. Harvest of adipose tissue and implant creation for other anatomic areas will continue to be reported using an unlisted CPT code for the applicable anatomic location.

*This response is based on the best information available as of 09/19/19.

 

 

 

 

 

 

 

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