Asked by: Kathleen Ehrenthaler
medical health ear nose and throat conditions

How many units do you bill for Synvisc One?

Last Updated: 7th May, 2021

10
SYNVISC Reimbursement Billing Codes
Synvisc-One and SYNVISC Billing Codes
J7325 For Synvisc-One and SYNVISC, per 1mg
Synvisc-One 48 in Units field of CMS-1500 Claim form or electronic equivalent
SYNVISC 16 in Units field of CMS-1500 Claim form or electronic equivalent
CPT

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In respect to this, how many units do you bill for Synvisc?

All settings should bill Synvisc-One as 3 units of code J7322.

Secondly, what is the CPT code for Synvisc One? HCPCS Code J7325 J7325 is a valid 2020 HCPCS code for Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg or just “Synvisc or synvisc-one” for short, used in Medical care.

Likewise, how much is a Synvisc One shot?

The cost for Synvisc-One intra-articular solution (48 mg/6 mL) is around $1,062 for a supply of 6 milliliters, depending on the pharmacy you visit. Prices are for cash paying customers only and are not valid with insurance plans.

Does Medicare pay for Synvisc One?

Within the hospital outpatient department, Synvisc-One and SYNVISC are covered as Separately Covered Outpatient Drugs (SCODs), which are paid at a rate of ASP + 4.3%. Of this allowable rate, Medicare will reimburse 80%, and the patient or patient's secondary insurer is responsible for the remaining 20% coinsurance.

Related Question Answers

D'Asis Coin

Professional

Can you bill CPT code 20610 twice?

When the same joint is treated more than once on the same date of service, even with aspiration followed by injection or with two injections to the same joint, you can only bill one CPT® 20610 code. No modifier is attached: you just bill 20610.

Chantell Kort

Professional

Can CPT 20610 be billed twice?

You may report multiple units of 20610 only if aspiration/injection is performed in more than one major joint (e.g., both knees or left knee and left shoulder).

Maraya Iparralde

Professional

How often can Synvisc one be given?

Synvisc One Dosage
The Synvisc brand of hylan G-F 20 is usually given once every week until you have received 3 injections. The Synvisc-One brand of this medicine is given only once. Your doctor will determine how many injections you should receive.

Teodula Leguinazabal

Explainer

Does Medicare pay for j2001?

MEDICARE PAID ON ALL EXCEPT THE J2001 WHICH IS THE LIDOCAINE.

Susanna Torhoff

Explainer

What is Synvisc made of?

What is SYNVISC made from? The injection contains a gel-like mixture made from a substance called hyaluronan (pronounced hy-al-u-ROE-nan) that comes from chicken combs. Hyaluronan is a natural substance found in the body and is present in very high amounts in joints.

Rosalio Nitze

Explainer

Does 20600 need a modifier?

20600: Arthrocentesis, aspiration and /or injection, small joint or bursa (eg, fingers; toes); without ultrasound guidance, with permanent recording and reporting. But, when the joint aspiration is done on two different small joint or major joints, we have to use 59 modifier with any of the cpt.

Zhiming Nibauer

Pundit

Does Medicare cover gel one injections?

Currently, Medicare will cover hyaluronan injections for the knee only. Medicare also requires X-ray evidence of the knee osteoarthritis. 13? Medicare will only cover hyaluronan injections if given no more frequently than every six months.

Dena Restituto

Pundit

What is the NDC number for j7325?

SYNVISC HYLAN G-F 20 KIT 3-2ML SYR/KIT
Package AWP: $1,492.73
J-Code: J7325
Strength: 8 MG/1 ML
Form: Solution
NDC Number: 58468009001 58468-0090-01

Prudencio Longaray

Pundit

Does Synvisc work for bone on bone?

Synvisc and related preparations are probably less effective once the cartilage is gone and there is bone on bone. Joint replacement at that point is probably the only solution.

Gian Gnegel

Pundit

Do gel shots help knees?

These are also known as gel injections. During treatment, a substance called hyaluronic acid is injected directly into the knee joint to add to the quantities of this acid naturally present the body. Hyaluronic acid injections can help to lessen joint pain as well as inflammation.

Xian Detkov

Pundit

What are the best gel shots for knees?

Synvisc-One® (hylan G-F 20) is an injection that supplements the fluid in your knee to help lubricate and cushion the joint, and can provide up to six months of osteoarthritis knee pain relief.

Viana Rabe

Teacher

Can I drive after a Synvisc injection?

After a Synvisc-One injection, you should avoid any strenuous activities for about 48 hours, including high-impact sports or weightlifting. Synvisc-One can provide up to six months of knee pain relief, and you can repeat the treatment. You can also have the injections in both knees, if necessary.

Niria Hanslbauer

Supporter

What is j7324?

J7324 is a valid 2020 HCPCS code for Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose or just “Orthovisc inj per dose” for short, used in Medical care.

Beilei Villard

Supporter

What is the J code for GEL one?

HCPCS Code J7326
J7326 is a valid 2020 HCPCS code for Hyaluronan or derivative, gel-one, for intra-articular injection, per dose or just “Gel-one” for short, used in Medical care.

Jordina Ezama

Supporter

How is Synvisc supplied?

SYNVISC (hylan g-f 20) is supplied in a 2.25 mL glass syringe containing one 2 mL (16 mg) dose of hylan G-F 20. The contents of the syringe are sterile and nonpyrogenic.

Ona Winkelstroter

Beginner

Is Hyalgan covered by Medicare?

HYALGAN® Patient Support
Treatment with HYALGAN® is covered by many health insurance plans, including Medicare, most managed care organizations, and other third-party insurers.

Lidiya Mahlmeyer

Beginner

How do you write a CPT code modifier?

CPT modifiers are added to the end of a CPT code with a hyphen. In the case of more than one modifier, you code the “functional” modifier first, and the “informational” modifier second.

Najem Mathis

Beginner

Is CPT code 20610 considered surgery?

Modifier 57: Decision for Surgery was added to code 99212. 20610: Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance. Modifier LT: Left side was added to code 20610.