Wiki Orthovisc sample for shoulder injection


Hortonville, WI
Best answers
Wondering if anyone has come across this: If we were to receive samples of Orthovisc, for example, to inject into the shoulder, since this is not cov'd by most insurance companies, are we allowed to still bill for the procedure (20610) and just not charge for the injectable? Hearing different answers on this, and wanted your opinions. Thanks.
Orthovisc - Shoulder

Hi -
I work for an Ortho practice and from our perspective 20610 is not worth the risk. You would be billing for a service that is being performed with an off-label use of the Orthovisic. This is a not a risk that I would be willing to take.

There is a case to be made for billing of 20610 if any fluid is being withdrawn from the joint, but other than that, I do not think that this is worth the risk.

Good Luck!