Wiki Gel- One Injections

[maryawinfield04]

I work for an Orthopaedic Surgeon who did a R- kne replacement on a patient in the hospital and provided a Gel- One injection in the L- knee, the facility didn't provide the injection it came from our office and it was given in the opposite knee.

Medicare is denying the claim stating that I need to submit to Medicare Part A BUT that's not supplied by the facility. Is there any way that I can possibly bill the injection seperatley through the professional POS?

Any advice would be greatly appreciated.

 

[CodingKing]

You will need to contact the facility for reimbursement.

 

[maryawinfield04]

You will need to contact the facility for reimbursement.

I billed under Part A but the claim denied again stating that I can't bill under part A or have the claim submitted to Part A

 

[hblakeman]

I don't think you can

I think in the hospital setting the physician can only bill for the Injection itself (20610), not the medication. Our office occasionally does cortisone injections similar to your scenario, but we only bill for the injection (of course cortisone is much less expensive than Gel-One and the facility provides the cortisone). As stated above, you may have to request reimbursement from the facility, if they billed for the Gel-One. If they did not, it might just be a write-off.

 

[CodingKing]

You can't bill part A. Drugs and Supplies are a facility expense and would have been covered by the DRG payment to the facility. The facility will need to reimburse the office.