ORTHOVISC®

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Managed Care and Reimbursement Support Services

 

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    HCFA 1500 Claim Form

    Proper coding and billing are critical steps to ensure prompt claim payment. Codes for ORTHOVISC® can be found on Claims Code Page. Below are several examples of HCFA 1500 Claim Forms for ORTHOVISC®. A common error that may lead to claim denial is submitting an incomplete claim form.

    ORTHOVISC® is reimbursed under J 7324. Medicare and Private Pay plans vary in relation to J 7324 for ORTHOVISC®. We encourage you to contact your local Medicare or Private Pay Insurance Carriers to verify patient specific coverage. In addition, ORTHOVISC®Line, 1-866-633-VISC (8472) can serve as a resource to identify codes.

    Example 1 - Initial Visit With Decision to Start ORTHOVISC® Example 2 - Return Visit for 2nd and 3rd Injection
    Initial Visit With Decision to Start ORTHOVISC® Return Visit for 2nd and 3rd Injection
    Example 3 - Follow Up Injection With Exam for Separate Condition Example 4 - Bilateral Injections
    Follow up injection with exam for separate condition Bilateral Injections

     

    The reimbursement information contained in this web site is provided for informational purposes only and represents no statement, promise, or guarantee by DePuy Mitek, Inc. concerning levels of reimbursement, payment, or charge. Similarly, all CPT and HCPCS codes are supplied for informational purposes only and represent no statement, promise, or guarantee by DePuy Mitek, Inc. that these codes will be appropriate or reimbursement will be made. The information presented is not intended to increase or maximize reimbursement by any payor. We strongly recommend that you consult your payor organization with regard to its reimbursement policies.

    JCode Source: Federal Register/Vol.72, No. 227,pp 66774/Tuesday, November 27, 2007. All Current Procedural Terminology (CPT) five-digit numeric codes, descriptions, numeric modifiers, instructions, guidelines, and other material are Copyright 2007 American Medical Association. All Rights Reserved.

    ICD-9 is based on the official version of the World Health Organization's Ninth Revision, International Classification of Diseases.

    CPT codes and descriptions only are Copyright 2007 American Medical Association. All Rights Reserved.

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    This site is published by DePuy Mitek, Inc., which is solely responsible for its contents.
    It is intended for healthcare professionals in the U.S. and contains U.S. based product information only.
    ORTHOVISC® is manufactured by and is a registered trademark of Anika Therapeutics, Inc. Distributed by DePuy Mitek, Inc.

    © DePuy Mitek, Inc. 2005 - 2010

    AN OFFICIAL HEALTH AND FITNESS PROVIDER

    Important Safety Information

    ORTHOVISC® is indicated in the treatment of pain in osteoarthritis (OA) of the knee in patients who have failed to respond adequately to conservative nonpharmacologic therapy and to simple analgesics, e.g. acetaminophen. In clinical studies, the most commonly reported adverse events were arthralgia, back pain, and headache. Other side effects included local injection site adverse events.

    ORTHOVISC® is contraindicated in patients with known hypersensitivity to hyaluronate formulations or known hypersensitivity (allergy) to gram positive bacterial proteins. ORTHOVISC® should not be injected in patients with infections or skin diseases in the area of the injection site or joint. Strict aseptic technique should be used. The effectiveness of more than 1 course has not been established.