Hyalgan J7321 no longer covered by Medicare?

[Cholula]

My biller informed me today that Medicare has denied all my claims for Hyalgan J7321 this year. Last year I had no problem getting it reimbursed from Medicare. Does anyone know what is going on and how to get it reimbursed? Thanks

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[DrCommonSense]

My biller informed me today that Medicare has denied all my claims for Hyalgan J7321 this year. Last year I had no problem getting it reimbursed from Medicare. Does anyone know what is going on and how to get it reimbursed? Thanks

Synvisc seems to be covered

 

[drpainfree]

no kidding!

The most recent Hyalgan injection that I did and get paid was on 1/5/2017. No issue! Have a few more claims that my biller hasn't submitted yet. Now it's concerning!

 

[olafa]

BCBS is not covering any hyaluronic injection- listed all in their denial

 

[Dog_luver]

My biller informed me today that Medicare has denied all my claims for Hyalgan J7321 this year. Last year I had no problem getting it reimbursed from Medicare. Does anyone know what is going on and how to get it reimbursed? Thanks

Is it also true that insurance is no longer paying for all US injections? That's what i was informed of by one of my attendings.

 

[DrCommonSense]

BCBS is not covering any hyaluronic injection- listed all in their denial

Most BC/BS appear to be covering it. There are many of them throughout the state.

Which state are you speaking about?

 

[drpainfree]

you guys are hijacking the original question

BC/BS and all private carriers have their own weird policies and they are state-dependent, too.

On the other hand, if Medicare starts denying HA injection (actually, more specifically in OP's question, hyalgan injection), then the denial would eventually trickle down to all payers.

 

[DrCommonSense]

you guys are hijacking the original question

BC/BS and all private carriers have their own weird policies and they are state-dependent, too.

On the other hand, if Medicare starts denying HA injection (actually, more specifically in OP's question, hyalgan injection), then the denial would eventually trickle down to all payers.

Medicare is covering it.

Various state BC/BS don't cover it starting in Mass. Most states still cover it though.