Proper Billing Units for HCPCS Code J7320
National Government Services has noticed improper billing units used for HCPCS code J7320, Hyaluronan or derivative, GenVisc 850, for intra-articular injection, 1 mg.
GenVisc 850 is indicated for the treatment of pain in osteoarthritis of the knee in patients who have failed to respond adequately to conservative non-pharmacological therapy and to simple analgesics (e.g., acetaminophen). GenVisc 850 is administered by intra-articular injection of the knee.
- The number of units is calculated by milligrams; each unit being equal to one milligram.
- There are 25 milligrams per dose of GenVisc 850; therefore each dose is 25 units.
When administered to one knee it is reported as 25 units of service. When administered bilaterally to both knees, report as 50 units of service.
The units of service are reported in box 24G on the CMS-1500 claim form or the electronic equivalent (Loop 2400; Field SV104).
Please note: It is required to report any drug wastage on a separate line utilizing the JW modifier. This will allow full payment of the drug.
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Posted 7/15/2021