Unanswered 0232T

[JanetA_51595]

CPT 0232T=Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed
I know this is not a payable diagnosis for orthopedics
My question is :
When the patient comes in we would have a ABN signed stating its a non covered service and collect from the patient
Would it be permissible to bill the EM to Medicare?

 

[EricS_89954]

CPT codes arent diagnosis, theyre service codes. Since this a level III (3) code we dont necessarily need to verify if the service is deemed necessary and supported by the diagnosis. Since this service is a "new technology" we need to have documentation. We also need to know if this is during the global surgery package (if the patient recently had surgery, that is) or if we need to add modifier 25 to the E/M code. Im still new so Im not completely sure lol

 

[JanetA_51595]

Hi there
sorry I guess I did not word this correctly
procedure cpt 0232T is not normally covered by insurance when seen in a orthopedic office for joint pain
The Provider is getting the ABN signed to bill the procedure 0232T as self pay but would it be appropriate to bill the EM code for the face to face visit