Basics about CPT or HCPCS code 0232T
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. This code is only used when PRP (Platelet rich plasma) is performed in a complete separate patient encounter from a surgical procedure.
Platelet rich plasma is used to treat non-healing injuries. Platelet rich plasma contains concentrated platelets that release growth factors including platelet derived growth factor and transforming growth factor, as well as other types. When injected into a non-healing injury, platelet rich plasma causes a chain reaction beginning with the release of growth factors that in turn act on fibroblasts, causing them to increase in number, which then accelerates repair of injured tissues.
0232T – Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed
The T at the end of the code denotes “temporary,” meaning that 0232T won’t stick around forever. Instead, it’s part of a group of temporary codes used primarily for emerging or experimental procedures and technologies. Usage of these codes is closely monitored by the CPT; eventually, most Level III temporary codes give way to a permanent Level I code with a set reimbursement amount.
Alternative codes used for Platelet rich plasma are G0460 & P9020.
G0460 – Autologous platelet rich plasma for chronic wounds/ulcers, including phlebotomy, centrifugation, and all other preparatory procedures, administration and dressings, per treatment
P9020 – Platelet rich plasma, each unit
In recent years some physicians have begun using bone marrow aspirate harvested from the iliac crest instead of drawn blood for PRP preparation, and using CPT code 38220. When only PRP injection is performed, then 0232T is the correct code to report. In 2018 the definition of 38220 was changed to reflect that it should be used only for diagnostic bone marrow aspiration.
Do and Don’t for HCPCS code 0232T
Do not report 0232T in conjunction with 20550, 20551, 20600, 20604, 20605, 20606, 20610, 20611, 20926, 36415, 36592, 76942, 77002, 77012, 77021, 86965, 0481T.
Do not report 38220-38230 for bone marrow aspiration for platelet rich stem cell injection. For bone marrow aspiration for platelet rich stem cell injection, use 0232T
According to UnitedHealthcare, this code may have a limit of 1 maximum frequency per day. Please consult your payer.
0232T is for the act of injecting PRP G0460 and P9020 are for the PRP Product itself. G0460 and P9020 are not alternate codes, rather any technical or global claim for 0232T should also include a code for either G0460 or P9020.
Hi, do you know the actual reimbursement rate for code 0232T with PRP G0460? thanks