Keep tabs on payer LCD, provider documentation to head off visco denials
Effective Oct 8, 2026
Published Oct 12, 2026
Last Reviewed Oct 8, 2026
Question: We were audited recently for 10 claims where the patients received Durolane, specifically, and all 10 claims were denied for lack of medical necessity. A customer service representative told me that the documentation had to provide quantifiable evidence of pain reduction and/or increased range of motion for a repeat injection. I don’t know what would be considered adequate demonstration of medical necessity for an initial injection. Medicare can’t tell me...
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