Billing and Coding: Platelet Rich Plasma

Coverage of platelet-rich plasma (PRP) is determined by Local Coverage Determination L39071 and must meet that LCD's reasonable and necessary criteria; services billed under G0465 follow NCD 270.3. Billing for non-covered PRP services as covered will be denied and appropriate modifiers must be used; complete, legible medical records with provider signature and documentation supporting ICD-10 and CPT/HCPCS coding are required.

"Coverage for platelet-rich plasma (PRP) is determined by Local Coverage Determination L39071; PRP is covered only when reasonable and necessary per that LCD."

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