Billing Coding Knee Injection Hyalgan, Supartz, Visco, Genvisc, Synvisc - J7325, J7321, J7328 20610

BILLING CODING KNEE INJECTION HYALGAN, SUPARTZ, VISCO, GENVISC, SYNVISC - J7325, J7321, J7328 20610

To all my blog readers that still are confused on how to properly bill, code and report these services. BILLING CODING KNEE INJECTION HYALGAN, SUPARTZ, VISCO, GENVISC, SYNVISC - J7325, J7321, J7328 20610 and more J-codes!

Osteoarthritis of the Knee

HCPCS Code Billing
Unit Drug
Name(s)Dosing frequency per series (per knee)
*Dose (per knee)
*Units per dose (per knee)
The following HCPCS codes are per dose codes:
J7321 per dose Hyalgan 3 to 5 weekly injections 20 mg once weekly ( 1 unit per knee )
J7321 per dose Supartz 3 to 5 weekly injections 25 mg once weekly  ( 1 unit per knee )
J7321 per dose Visco-3 3 weekly injections 25 mg once weekly  ( 1 unit per knee )
J7323 per dose Euflexxa 3 weekly injections 20 mg once weekly  ( 1 unit per knee )
J7324 per dose Orthovisc 3 to 4 weekly injections 30 mg once weekly  ( 1 unit per knee )
J7326 per dose Gel-One Single injection** 30 mg x 1 dose  ( 1 unit per knee )
J7327 per dose Monovisc Single injection** 88 mg x 1 dose  ( 1 unit per knee )

HCPCS Code Billing
Unit Drug
Name(s)Dosing frequency per series (per knee)
*Dose (per knee)
*Units per dose (per knee)
The following HCPCS codes are per mg codes (not per dose):
J7328 per 0.1 Gelsyn-3 3 weekly injections 16.8 mg once ( 168 units per knee )
J7329 per 1 mg TriVisc 3 weekly injections 25 mg once weekly( 25 units per knee )
J7318 per 1 mg Durolane Single Injection** 60 mg x 1 dose ( 60 units per knee )
J7320 per 1 mg Genvisc 850 3 to 5 weekly injections 25 mg once weekly ( 25 units per knee )
J7325 per 1 mg Synvisc 3 weekly injections 16 mg once weekly ( 16 units per knee )
J7325 per 1 mg Synvisc-One Single injection** 48 mg x 1 dose ( 48 units per knee )
J7322 per 1 mg Hymovis 2 weekly injections 24 mg once weekly ( 24 units per knee )
J7331 per 1 mg Synojoynt 3 weekly injections 20 mg once weekly ( 20 units per knee )
J7332 per 1 mg Triluron 3 weekly injections 20 mg once weekly ( 20 units per knee )

Anatomy of the Knee

These injections are crossing over to primary: OA (eg. M17.0) and secondary: Knee Joint Pain (M25.561, M25.562)

CPT Codes:
20610 (unilateral), add 77002 if you perform under Fluoroscopy
20611 (unilateral) - if you perform under ultrasound

If the injection is for Therapy. Make sure you document your notes as follows (example):
1/3 - 1st Injection
2/3 - 2nd Injection (append modifier EJ) for the drug code 
3/3 - 3rd Injection (append modifier EJ) for the drug code

Reference Source: https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55036&ver=59
Billing and Coding: Hyaluronan Acid Therapies for Osteoarthritis of the Knee
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