Medical Billing Forum
General Category => General Questions => : nlbarnes64 February 13, 2014, 03:36:17 PM
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What is the reimbursement for Synvisc-One? This is a work comp claim. Also, in your claim where you would list the NDC, do you enter 48 U? And on the line item of the claim, the quantity of injections? I looked up on the work comp fee schedule, California, & it looks like it's $524.62/unit or $149.89/ unit. I haven't used the calculator on the CA work comp fee schedule in a while & wasn't sure what to put in one of the fields to calculate.
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This is specific to CA workers' comp. I don't have any experience, sorry! :( Maybe somebody else?
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It can even be Medicare guidelines. Not necessarily work comp please.
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I found the info I needed. Medicare reimbursement is $12.86 / unit.
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Good. Are you still looking for help on where to put the NDC Number? Are you billing on a CMS form or a UB04?
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I'm billing on a HCFA1500. I know where to put the NDC, & in the sam part do you enter 48 units w/ qty 1 on the line item or vice versa? Does that make sense? I can never remember.
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Also, in your claim where you would list the NDC, do you enter 48 U? And on the line item of the claim, the quantity of injections?
You confused me with this statement. I thought you meant field 48 and there is no 48 on the CMS so I thought maybe you meant UB04. ;D
Yes that is correct.
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