tci General Surgery Coding Alert - 2008 Issue 11

Reader Questions: Avoid Cat. I Code for Autologous Plasma Grafts

Question: Is there a CPT code for the use of autologous platelet rich plasma grafts that are being used for postoperative non-healing wounds? South Dakota Subscriber Answer: CPT does not contain a category I code that describes autologous platelet rich plasma grafts appropriately. Some billers have been reporting 20926 (Tissue grafts, other [e.g. paratenon, fat, dermis) with success. But unless you-ve been specifically instructed by your payer, this code is inappropriate and could very likely result in trouble at audit time, as well as payer refund requests. A review of policy statements from several payers specifically warn against...

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