Injections performed in surgery.


Loudon, TN
Best answers
Our physician wants to perform Synvisc injections in surgery. He is performing a left knee procedure and would like to inject Synvisc in the right knee. The hospital does not have this medicine and the physician would bring it from the office. Has anyone had to do this and will we be able to be reimbursed for the drug? If so would the place of service for the Synvisc be our office and the actual injection code 20610 the facility?


True Blue
Best answers
Medications that are administered at a hospital would need to be billed by the hospital as those charges would usually be inclusive to the facility's case rates for the procedure and would not be payable to an outside provider. Also, it is likely against the hospital's policy for a provider to bring in medications since it would bypass the hospital's pharmacy quality control process and potentially expose the hospital to liability. An option I've seen used, if the hospital pharmacy is unwilling to purchase the drug, is that the hospital will have the patient's outside pharmacy supply a drug under the patient's pharmacy benefit and deliver it to the hospital for administration on site.

I'd recommend your provider contact the hospital's pharmacy to work this out - it needs to be done with the knowledge and participation of the hospital to avoid a potential problem down the road. Hope this helps some.