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

7/13/2022

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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!
Picture
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 )
Picture
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
CPT 2022. CPT is a trademark and owned by the AMA - American Medical Association.
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    Ms. Pinky Maniri-Pescasio, MSC, CSPPM, CRCR, CSBI, CSPR, CSAF is the Founder of GoHealthcare Consulting. She is a National Speaker on Practice Reimbursement and a Physician Advocate. She has served the Medical Practice Industry for more than 25 years as a Professional Medical Practice Consultant.

    Current HFMA Professional Expertise Credentials: 
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  • About
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  • Leadership
  • Contact Us
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  • READ OUR BLOG
  • Let's Meet in Person
    • 2023 ORTHOPEDIC VALUE BASED CARE CONFERENCE
    • 2023 AAOS Annual Meeting of the American Academy of Orthopaedic Surgeons
    • 2023 ASIPP 25th Annual Meeting of the American Society of Interventional Pain Management
    • 2023 Becker's 20th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference
    • 2023 FSIPP Annual Conference by FSIPP FSPMR Florida Society Of Interventional Pain Physicians
    • 2023 New York and New Jersey Pain Medicine Symposium
  • Frequently Asked Questions and Answers - GoHealthcare Practice Solutions
  • Readers Questions
  • Artificial Intelligence Division