Synvisc injections

mieie4444

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My doctor does the synvisc injections. We use the meds that the pt has already paid for. We bill for the 20610 arthrocentesis since we drain the knee first and then we dont bill for the meds since the patient has already paid for them. I have a really hard time getting the insurance to pay for this code 20610 since we are not billing for the meds at the same time. Do you have any ideas on how to get it paid?

Thanks:confused:
 

mitchellde

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You can bill for only one unit of the 20610, as long as you are not trying to bill for both the arthrocentesis and the injection. We bill the J code for the med with a $.01 charge which is then adjusted off. This has always been acceptable to the payers.
 

kathy a

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What diagnosis code are you using? I use the 715.16 and use a RT or Lt on the injection. I do not have any problems getting paid.
Kathy Albert,CPC
 

armen

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You can bill for only one unit of the 20610, as long as you are not trying to bill for both the arthrocentesis and the injection. We bill the J code for the med with a $.01 charge which is then adjusted off. This has always been acceptable to the payers.
Did you ever tried to bill for both inj and arthrocentesis?
 

mitchellde

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A modifier will make it pass the edits HOWEVER you are not to bill for both in the same joint. The code say aspiration and/or injection
 

armen

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A modifier will make it pass the edits HOWEVER you are not to bill for both in the same joint. The code say aspiration and/or injection


That is what Im trying to explain to our clinic :) they keep marking 20610 twice on superbills asp & inj and I cant just append the modifier to bypass the edit. I though maybe somebody found other RIGHT ways to it:)
 
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