Billing and Coding: Platelet Rich Plasma Injections for Non-Wound Injections

The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for Platelet Rich Plasma Injections for Non-Wound Injections L39060. NOTE: 0232T is the HCPCS code representing platelet rich plasma injection, any site. It is Noridian's expectation that the HCPCS code P9020 (platelet rich plasma, each unit) be billed for one or more units of PRP transfused in the treatment of the conditions/coagulopathies for which it is indicated. This code MUST NOT be used to describe the injection of PRP into a specific site. The Center for Medicare and Medicaid Services (CMS) National Coverage Determination (NCD) 270.3 outlines the coverage of PRP for the treatment of certain chronic non-healing wounds. Please refer to NCD 270.3 for further information regarding coverage indications. Should PRP meet nationally covered indication as stated in NCD 270.3, HCPCS codes G0460/G0465 must be used accordingly. Do not use code 86965, Pooling of platelets or blood products for injection(s) of platelet rich plasma. Injections that utilize a kit to create the platelet rich plasma, must be billed with category III code 0232T, and according to the CPT® codebook is not a transfusion medicine service.