Wiki injection of Supartz

[dalanicks@aol.com]

hi im new to orthopedics we have a few doctors that keep injecting Supartz into the hip, this drug is used for the knee, of course they are not getting paid, i will look further into this since I am new, but does anyone have or no any information on billing Supartz, J7321, i beleive they bill it with 20611, thank you

 

[CodingKing]

I'm not sure about other carriers but Empire Blue Cross Blue Shield find it investigational and not medically necessary for other than Knee and one course for TMJ

https://www.empireblue.com/medicalpolicies/policies/mp_pw_a049863.htm

 

[dalanicks@aol.com]

injection of supartz

oh okay thats what i figured, thank you

 

[kivbar16]

Check your local LCD, however most payers consider Supartz (or any other Hyaluronans: Synvisc, Gel One, etc) investigational for anything other than OA of the knee. I would recommend having patients sign an ABN, this at least gives you the option to bill the patient.

You should educate your providers as well. I know a number of MD's like to use these meds in the shoulder for OA there...still not payable. A lot of lost revenue without the ABN's.

Also, be sure they are using US when billing the 20611 (w/o US, it of course is 20610).

 

[dalanicks@aol.com]

supartz

yes i said the same thing to myself, i am going to tell them that and yes they do bill 26011 thanks alot i appreciate it