icd code for supartz

What does supartz stand for?

Supartz (sodium hyaluronate). Prescribing information. Durham, NC: Bioventus; revised April 2015. Bioventus, LLC. Bioventus launches Supartz FX now with expanded safety label for repeat injection cycles in knee osteoarthritis. Press Release.

What is the HCPCS code for Hyalgan supartz?

J7321 is a valid 2019 HCPCS code for Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose or just “ Hyalgan supartz visco-3 dose ” for short, used in Medical care .

What is the HCPCS code for supartz FX 25MG injection series?

The patient should be specifically preauthorized for their SUPARTZ FX (sodium hyaluronate) 25mg injection series (HCPCS code J7321). The BioLinx reimbursement hotline is available for insurance verification and prior authorization support.

What is supartz by Bioventus?

Bioventus LLC. Supartz (sodium hyaluronate). Prescribing information. Durham, NC: Bioventus; revised April 2015. Bioventus, LLC. Bioventus launches Supartz FX now with expanded safety label for repeat injection cycles in knee osteoarthritis. Press Release.

How do you bill for Supartz?

CPT code J7231, J7323, J7324, J7325 – Hyaluronate Polymers, Orthovisc J codecpt code and description.J7321 Hyaluronan or Derivative, Hyalgan or Supartz, For Intra-Articular Injection, Per Dose.J7323 Hyaluronan or Derivative, Euflexxa, For Intra-Articular Injection, Per Dose.More items...

How do you bill Synvisc injections?

The new HCPC code, J7325, is reported for both Synvisc and Synvisc One, the injection code is easy, and so we will start there— Bill using CPT 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.

What is J7321?

HCPCS Code. Description. J7321. Hyaluronan or derivative, HYALGAN or SUPARTZ, for intra-articular injection, per dose.

What is the CPT code for Synvisc injection?

SYNVISC Reimbursement Billing CodesSynvisc-One and SYNVISC Billing CodesICD-10-CMSYNVISC16 in Units field of CMS-1500 Claim form or electronic equivalentCPT20610Arthrocentesis, major joint or bursa * Include modifiers -RT, -LT or 50 (bilateral)22 more rows

What is Supartz knee injection?

SUPARTZ FX is a 5-injection hyaluronic acid series that can relieve knee osteoarthritis pain for up to 6 months. Clinical studies have shown that some patients may see their osteoarthritis symptoms improve with only 3 injections of SUPARTZ FX.

Can I bill an office visit with a joint injection?

Answer: Unfortunately, no. It is true that an evaluation and management code, an E/M or office visit, can be reported with a minor procedure such as an injection, but only if the E/M is significant and separate and exceeds the “pre-service evaluation” that is inherent to the injection.

What is the CPT code for hyaluronic acid injections?

Billing the injection procedure The procedure code (CPT code) 20610 may be billed for the intraarticular injection.

What is the CPT code for Visco injection?

Group 2CodeDescriptionJ7321Hyalgan supartz visco-3 doseJ7322Hymovis injection 1 mgJ7323Euflexxa inj per doseJ7324Orthovisc inj per dose9 more rows

Does Medicare pay for Supartz injections?

Do Medicare prescription drug plans cover Supartz? No. In general, Medicare prescription drug plans (Part D) do not cover this drug.

What is procedure code J7325?

HCPC's code J7325 is defined as 1 mg. J7325 Hyaluronan or Derivative, Synvisc or Synvisc-One, For Intra-Articular Injection, 1mg.

What is the ICD 10 code for M17 11?

M17. 11, unilateral primary osteoarthritis, right knee.

How do you code bilateral knee injections?

The CPT code 20611 is for an arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee or subacromial bursa with ultrasound guidance, with permanent recording and reporting). The code is billed twice because this was a bilateral procedure.

General Information

CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

CMS National Coverage Policy

Title XVIII of the Social Security Act, Section 1833 (e) states that no payment shall be made to any provider of services or other person under this part unless there has been furnished such information as may be necessary in order to determine the amounts due such provider or other person under this part for the period with respect to which the amounts are being paid or for any prior period..

Article Guidance

This Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) L33767 Viscosupplementation Therapy for Knee. Please refer to the LCD for reasonable and necessary requirements.

ICD-10-CM Codes that Support Medical Necessity

It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim (s) submitted.

ICD-10-CM Codes that DO NOT Support Medical Necessity

All those not listed under the “ICD-10 Codes that Support Medical Necessity” section of this article.

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.

What is the 2021 HCPCS code for hyaluronan?

J7321 is a valid 2021 HCPCS code for Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose or just “ Hyalgan supartz visco-3 dose ” for short, used in Medical care .

What does modifier mean in medical?

A modifier provides the means by which the reporting physician or provider can indicate that a service or procedure that has been performed has been altered by some specific circumstance but not changed in its definition or code.

What is BETOS code?

A code denoting Medicare coverage status. The Berenson-Eggers Type of Service (BETOS) for the procedure code based on generally agreed upon clinically meaningful groupings of procedures and services. A code denoting the change made to a procedure or modifier code within the HCPCS system.

What is the code for Supartz?

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.

Is Supartz a 1 mg drug?

Supartz is covered in #1 in the article. It's possible that they are getting this confused with Synvisc for the "1mg" info, since that drug is billed differently, per mg. The HCPCS description for J7321 does clearly state "per dose", which is 25mg.

General Information

CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

CMS National Coverage Policy

Title XVIII of the Social Security Act, Section 1833 (e) states that no payment shall be made to any provider of services or other person under this part unless there has been furnished such information as may be necessary in order to determine the amounts due such provider or other person under this part for the period with respect to which the amounts are being paid or for any prior period..

Article Guidance

This Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) L35427 Hyaluronan Acid Therapies for Osteoarthritis of the Knee.

ICD-10-CM Codes that Support Medical Necessity

It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim (s) submitted.

ICD-10-CM Codes that DO NOT Support Medical Necessity

All those not listed under the “ICD-10 Codes that Support Medical Necessity" section of this article.

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.

What is the code for a hip arthrectomy?

Use code 20610 for an Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa). Use this code if an SI Joint Injection is done without any imaging (instead of 27096 or G0260)

What is CPT code for bursa arthrocentesis?

For example, when a small joint or bursa arthrocentesis, aspiration and/or injection (CPT code 20600) is performed, anesthesia may be provided by the surgeon using a digital nerve block (CPT code 64450). Because this type of anesthesia provided by the surgeon performing the procedure is not separately payable, CPT code 64450 is bundled into CPT code 20600 when the same physician performs both procedures.

What is the meaning of Title XVIII of the Social Security Act?

This section states that no payment shall be made to any provider for any claims that lack the necessary information to process the claim.

What is CPT code 25115?

For example, CPT code 25115 describes a radical excision of a bursa or synovia of the wrist. It is standard surgical practice to preserve neurologic function by isolating and freeing nerves as necessary. A neuroplasty (e.g. CPT code 64719) should not be reported separately for this process. Therefore, CPT code 64719 is bundled into CPT code 25115.

When did the coding change for arthrocentesis?

As of January 1, 2015, there is a coding change to the arthrocentesis injection codes (20600 – 20611). The codes are now separated to reflect an injection/aspiration with or without ultrasound guidance. The coding corner below will demonstrate an example of this change.

What is 20611?

20611 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting (Do not report 20610, 20611 in conjunction with 27370, 76942) (If fluoroscopic, CT, or MRI guidance is performed, see 77002, 77012, 77021)