tci Part B Insider - 2008 Issue 43

Reader Question: Verify Location for Synvisc Coding Or Risk Pay

Question: Which diagnosis should I report to support Synvisc administration?Answer: Diagnosis coding possibilities for the knee include 715.1x (Osteoarthrosis, localized, primary), but 715.3x (Osteoarthro-sis, localized, not specified whether primary or secondary) is usually the go-to code because physicians do not typically state whether the OA is "localized, primary" or "localized, secondary." You could also look at 715.16 (Osteoarthrosis, localized, primary; lower leg), 715.26 (Osteoarthrosis, localized, secondary; lower leg), 715.36 (Osteoarthrosis, localized, not specified whether primary or secondary; lower leg), and 715.96 (Osteoarthrosis, unspecified whether generalized or localized; lower leg). You should...

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