Your question does not indicate exactly what your issue is with payment but the reporting of the drugs are pretty straightforward. However, 2010 did bring a new challenge with the new code J7325 was introduced and is used for both Synvisc and Synvisc One.
The injection code is easy, so we will start there--20610
The reporting of Synvisc is dependent on what drug you are using.
Synvisc One- is a concentrated dose, is only administered one time and is reported with 48 units. J7325 x 48
Synvisc -same drug, but less concentrated is administered over three different visits. So at each visit, you will report 20610, J7325 x 16 units. Report this for the first , second and third injection.
Hope this helps answer your question and reimbursement dilemma. If you forget the units, Medicare will only reimburse you for one unit!
This and many more topics are covered in the AAOS Sponsored National Coding Courses presented by KarenZupko & Associates, Inc. Visit www.karenzupko.com for more information on the 2011 courses and locations!
This is very helpful - nice to browse the articles. One question, how do you figure out how many units are in the syringe. Where did you find the 16 unit for the 2ml syringe and 48 for the 10ML 1 dose? This is what is confusing me.
Synvisc-One is administered as a single intra-articular injection.The syringe containing Synvisc-One is intended for single use.Synvisc-One is supplied in a 10-mL glass syringe containing 48mg of Hylan G-F 20.
If your physician stated he injected Synvisc-One then he injected 48mg, which is the same as 6mL.
SYNVISC is administered by intra-articular injection once a week (one week apart) for a total of three injections.SYNVISC is supplied in a 2.25 mL glass syringe containing 16 mg of Hylan G-F 20.
If your physician stated he injected Synvisc then he injected 16mg, which is the same as 2mL.
(mg is weight. mL is volume. The mg to mL won't be the same formula for other drugs)