KMCFADYEN
Expert
Has anyone billed for Monovisc?
It is a new viscosupplementation along the lines of Orthovisc, Synvisc, etc for osteoarthritis of the knee that some sales rep has talked my doctors into using claiming they will reap an increase in revenue (about $20) because the cost is less than the competitor's brands. Currently I am billing for Orthovisc (J7324), Synvisc One and three shot (J7325), Euflexxa (J7323), and Supartz (J7321). I have yet to speak to the sales rep for this new drug but the info they have given my doctor is that we are to use J3490. I certainly hope this is not the case! I remember having to use this unclassified drug code for Synvisc when it first came out. it was a lot of work to not only get the claim paid but to get the proper reimbursement. we had to send the notes and invoice and appeal the denial of J3490.
It is a new viscosupplementation along the lines of Orthovisc, Synvisc, etc for osteoarthritis of the knee that some sales rep has talked my doctors into using claiming they will reap an increase in revenue (about $20) because the cost is less than the competitor's brands. Currently I am billing for Orthovisc (J7324), Synvisc One and three shot (J7325), Euflexxa (J7323), and Supartz (J7321). I have yet to speak to the sales rep for this new drug but the info they have given my doctor is that we are to use J3490. I certainly hope this is not the case! I remember having to use this unclassified drug code for Synvisc when it first came out. it was a lot of work to not only get the claim paid but to get the proper reimbursement. we had to send the notes and invoice and appeal the denial of J3490.