Bone Marrow Aspirate

Question:

Good afternoon,
One of our physicians is performing an injection of bone marrow aspirate concentrate into infraspinatus, supraspinatus tendons and the glenohumeral joint, under ultrasound guidance. Bone marrow was aspirated from bilateral iliac crests under US guidance and processed via centrifugation. How should this be reported?
Thank you

Answer:

CPT Category III code 0232T was introduced in 2010 for reporting injection of platelet rich plasma to a targeted site; the code definition includes all harvesting, preparation, and image guidance for the service. In August 2010 the AAOS published guidance in AAOS Now which explained “The new code is to be used only when PRP is performed in a complete separate patient encounter from a surgical procedure.”

Based on this direction, when PRP is injected during another procedure, whether using drawn blood or bone marrow aspirate, it is not separately reportable with the primary surgical service.

If PRP injection is the only service performed, then 0232T is the correct code. In recent years some physicians have begun using bone marrow aspirate harvested from the iliac crest instead of drawn blood for PRP preparation, and reporting the harvesting using CPT code 38220. The May 2012 edition of CPT Assistant clarified that 0232T is the only code reportable for PRP injection, whether performed using drawn blood or harvested bone marrow aspirate. In 2018 the definition of 38220 was changed to reflect that it should be used only for diagnostic bone marrow aspiration. New code 20939 should be used when bone marrow aspiration is performed for bone grafting, for spine surgery only, via a separate incision. CPT instructs to use 20999 for bone grafting, other than spine surgery and other therapeutic musculoskeletal applications.

*This response is based on the best information available as of 12/04/25.