CPT Code for Platelet-Rich Plasma (Blood Spinning) Therapy
There is no specific CPT code dedicated exclusively to platelet-rich plasma (PRP) therapy or "blood spinning." Instead, providers typically use unlisted procedure codes or codes that describe the specific anatomical site where PRP is being administered.
Coding Options for PRP Therapy
When billing for PRP therapy, providers typically use one of the following approaches:
0232T: Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed (This is a Category III code, which is temporary)
Unlisted procedure codes based on anatomical location:
- 20999: Unlisted procedure, musculoskeletal system, general
- 22999: Unlisted procedure, spine
- 23929: Unlisted procedure, shoulder
- 27599: Unlisted procedure, femur or knee
- 29999: Unlisted procedure, arthroscopy
Site-specific injection codes plus blood collection/processing codes:
- Anatomical site injection code (e.g., 20610 for major joint injection)
- 36415: Routine venipuncture
- 86999: Unlisted transfusion medicine procedure (for processing the blood)
Important Considerations for PRP Coding
Standardization issues: PRP preparation methods are poorly standardized, with variable concentrations of platelets, growth factors, and other blood components 1. This contributes to the lack of a specific CPT code.
Documentation requirements: When using unlisted codes, detailed documentation is essential, including:
- PRP preparation methodology
- Amount of autologous blood collected
- Baseline platelet concentration and volume
- Activation method used (if any)
- Site of injection and technique
Insurance coverage: Many insurance companies consider PRP therapy experimental/investigational and may not cover it 2. Verification of coverage is recommended before performing the procedure.
Preparation Methods Impact
The preparation method for PRP can vary significantly, affecting both coding and clinical outcomes:
- Platelet concentrations range from 2-9 times baseline levels 3
- Various anticoagulants may be used (citrate, ACD, CPD), though EDTA should be avoided 1
- Activation methods vary (thrombin, calcium chloride, collagen exposure) 1
Billing Pitfalls to Avoid
- Unbundling: Don't separately bill for components that should be included in a single code
- Upcoding: Don't use codes for more complex procedures than what was performed
- Lack of documentation: Insufficient documentation of the PRP preparation and administration process
- Misrepresenting medical necessity: Ensure the indication for PRP is clearly documented and medically appropriate
Remember that while PRP has been used in various medical fields including orthopedics, sports medicine, and aesthetics 4, 5, the lack of standardization in preparation methods and application protocols continues to be a challenge for both clinical practice and billing purposes 2.