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Coding and Reimbursement for Regenerative Medicine

Jul 18, 2017

Regenerative medicine is an exciting field for physicians as well as patients. In theory, it holds so much promise for rehabilitation, recovery, decreasing pain, and increasing function. Unfortunately, more studies are needed for physicians to have more confidence that these procedures are helpful and appropriate. With that concept in mind, it brings a host of issues to the correct coding of such procedures.

Most CPT® codes billed by providers daily are Category I CPT codes. However, most of the codes for regenerative medicine procedures are Category III CPT codes. These codes are designated as a temporary set of codes reserved for emerging technologies, services, and procedures. As clinical evidence grows to support use of the procedure, a Category III code can be converted to a Category I code...

Read the full article in your July issue of The Physiatrist.