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Synvisc injection with chondroplasty

  1. #1
    Question Synvisc injection with chondroplasty
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    My doctor wants to start giving Synvisc injections at the time of a chondroplasty because of a new study that has come out. The diagnosis code for the chondroplasty and the Synvisc injection would be the same. The patient will have to come back one week post op for the second injection and I was thinking I needed to use modifier 58 for 20610 then. Should I use a 51 modiifier on 20610 at time of surgery? Do you think that the injection 20610 and Synvisc J7325 will be included with the chondroplasty? Thanks!
    IHAGEE

  2. #2
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    Quote Originally Posted by ihagee View Post
    My doctor wants to start giving Synvisc injections at the time of a chondroplasty because of a new study that has come out. The diagnosis code for the chondroplasty and the Synvisc injection would be the same. The patient will have to come back one week post op for the second injection and I was thinking I needed to use modifier 58 for 20610 then. Should I use a 51 modiifier on 20610 at time of surgery? Do you think that the injection 20610 and Synvisc J7325 will be included with the chondroplasty? Thanks!

    If Medicare--you can forget about getting paid for the 20610 for 90 days following the chondroplasty per NCCI.

    Good luck with the other carriers
    Mary, CPC, CANPC, COSC

  3. #3
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    Even If I put a 58 modifier(stage/related procedure) on the last 2 injections (20610-58) you don't think that will work? Do you think I'll have any problem getting paid for the J7325?

    Thanks!!!!
    IHAGEE

  4. #4
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    If its Medicare you dont even have a chance of being paid because the NCCI states that you can not charge for it.

    The Synvisc however, is reimbursable, just not the injection itself (20610)
    Mary, CPC, CANPC, COSC

  5. #5
    Smile
    thanks for your help!
    IHAGEE

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