Billing and Coding: Intraarticular Knee Injections of Hyaluronan

Medicare covers intraarticular hyaluronan (viscosupplementation) for symptomatic osteoarthritis of the knee when the patient has failed at least 3 months of conservative therapy and radiographic evidence supports the diagnosis. Dosing and frequency must follow the FDA-approved package insert for the specific HCPCS-coded product, documentation of prior benefit is required for repeat series (minimum 6-month interval), and billing must follow modifiers and units rules (EJ for subsequent injections in a series, JW for discarded drug, appropriate RT/LT or -50 modifiers).

"Intraarticular hyaluronan is covered for treatment of symptomatic osteoarthritis of the knee in patients who have failed to respond adequately for at least 3 months to simple analgesics and conserv..."

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