The information provided should be utilized for educational purposes only. Please consult with your billing and coding expert. Facilities are ultimately responsible for verifying the reporting policies of individual commercial and MAC/FI carriers prior to claim submissions.
Platlet-rich plasma
1. CPT 0232T, a Category III code, was introduced in July 2010 for the administration of PRP and is listed as a new Category III code in 2011. CPT also added related guidelines to the instructions.
2. CPT codes 20551 for injections in the single tendon origin/insertion, and CPT 20926 for tissue grafts and other, reference the PRP Category III code for work associated with injections. This is an all-inclusive code for PRP used as an adjunct to surgical procedures, not separately reportable.
Hip arthroscopy
3. CPT 29914 was added for surgical hip arthroscopy with femoroplasty (i.e., treatment of cam lesion).
4. CPT 29915 was added for surgical hip arthroscopy with acetabuloplasty (i.e., treatment of pincer lesion)
5. CPT 29916 as added for surgical hip arthroscopy with labral repair. This should not be reported when the repair is performed secondary to an acetabuloplasty.
6. The new additions include synovectomy and labral debridement/chondromplasty when performed at the same session.
Spine
7. CPT 20930 was revised to include placement of osteopromotive material as one of the material used in the procedure.
8. CPT 20931 was revised to reference its applicability in spine surgery only.
9. There is a deletion of the reference to threaded bone dowels in CPT 22851, which are now reported with CPT 201931.
10. CPT 22551 (arthrodesis, anterior interbody, including disc space preparation, discectomy osteophytectomy and decompression of the spinal cord and/or nerve roots in cervical below C2) and CPT 22552 (+22552 for arthrodesis, anterior interbody, including disc space preparation, discectomy osteophytectomy and decompression of the spinal cord and/or nerve roots in cervical below C2, each additional interspace) were added.
11. The guideline instructions for CPT 63075 and 22554 instruct the surgeon not to report the two codes together when both procedures are performed at the same site and same level during the same session.
Read the AAOS Now report on key CPT changes for orthopedic surgeons.
Read other coverage from AAOS:
– AAOS: Guideline and Recommendations on Rotator Cuff Repair
– AAOS: 5 Tips for Selecting Orthopedic Physician Partners
– AAOS: 3 Points on Orthopedic Surgeon Risk Management and Prevention
