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HCPCS codes for knee injection

This article was originally published in The Gray Sheet

Executive Summary

CMS heard feedback from manufacturers of hyaluronic acid-based osteoarthritis knee treatments at a public HCPCS coding and payment meeting May 11. A preliminary decision from the agency found that five such products on the market show "no significant therapeutic distinctions," leading the agency to propose that they all be grouped under a single code. CMS also solicited comments on maintaining the current system by which the products fall under two codes - one for chemically altered hyaluronan and one for natural hyaluronate products. Attorney Paul Radensky, MD, who presented on behalf of Sanofi-Aventis (Hyalgan), argued for the second year that each product should be given its own code based on molecular weight (1"The Gray Sheet" June 20, 2005, p. 3). Hyalgan competes with Genzyme's Synvisc, Smith & Nephew's Supartz, Johnson & Johnson/Ortho Biotech's Orthovisc and Ferring Pharmaceuticals' Euflexxa. The agency will make a final coding determination in November...
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