I need some clarification about J7321. The description for this code is: Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose. My provider's secondary office insists that because the drug is 25mg/2.5ml, they can bill 2 units to Medicare and 3 units to commercial payers so he wants it billed this way in his primary office. They were told by someone at Medicare that it is acceptable. I disagree with this as I cannot find anything that supports each "dose" being 1ml. The Supartz website lists each syringe as 25mg.
What do you all do as far as the number of units and how are you interpreting the code description?
To be clear, we are talking about a single injection into one knee, not a bilateral procedure.
Thanks in advance!
What do you all do as far as the number of units and how are you interpreting the code description?
To be clear, we are talking about a single injection into one knee, not a bilateral procedure.
Thanks in advance!