In 2010, the American Medical Association set a new precedent, they published a temporary code for a PRP Injection BEFORE the PRP was ever FDA cleared to use as an Injection...To my knowledge, the AMA has never assigned a CPT Code to a procedure prior to that procedure having FDA clearance of use.
In July of 2010, the AMA published a Tracking Code 0232T for the use of PRP as an INJECTION for the treatment of Tendonopathy. This eliminated the use of other codes for reimbursement for PRP Injections only!
The AAOS has taken a position that the use of PRP as a surgical adjunct within the Surgical Wound Site PRIOR to surgically closing the wound is inclusive in the 0232T and/or Medicare’s 2008 determination on PRP.
There are currently Office Coding Seminars that are locally held in each State that are disseminating the AAOS interpretation as fact. Many experts in the field of PRP feel that the AAOS interpretation of the 0232T code is inaccurate and each office manager should review the 2011 CPT Code Book and Medicare’s Definition of the CPT Code 20926 for themselves.
The 2011 CPT Code book describes 0232T as “Injection(s) of Platelet Rich Plasma, any site, including image guidance, harvesting and preparation when performed”. This clearly implies the use of PRP as an Injection, nothing in regards of its surgical use.
In the 2011 CPT Code Book under CPT Code 20926, it states “(for Injection(s) of Platelet Rich Plasma, use 0232T – Clearly implying that code 20926 is still valid for other covered uses of PRP. And currently, the ONLY Covered use for PRP is a Surgical Procedure for soft tissue and bony structures.
This new T code has caused much confusion in Medical Offices...Understandably so, since the AMA published a code for a new procedure that was just starting to become popular, had no studies as to it's effectiveness, and was currently going through the proper channels of the FDA to get clearance, before submitting a request for a code.
CPT Code 0232T is for the use of PRP as an Injection Only!