The following codes may be appropriate when billing for ZILRETTA™ (triamcinolone acetonide extended-release injectable suspension) and related service. This information is for reference only. Please contact your patient’s health plan or work with FlexForward to confirm coding for a specific plan.

ICD-10 Codes1
M17.0 Bilateral primary osteoarthritis of knee
M17.11 Unilateral primary osteoarthritis, right knee
M17.12 Unilateral primary osteoarthritis, left knee
M17.2 Bilateral post-traumatic osteoarthritis of knee
M17.31 Unilateral post-traumatic osteoarthritis, right knee
M17.32 Unilateral post-traumatic osteoarthritis, left knee
M17.4 Other bilateral secondary osteoarthritis of knee
M17.5 Other unilateral secondary osteoarthritis of knee
HCPCS2-4
J3490 Unclassified
drugs
Physician office
Hospital outpatient
C9399 Unclassified
drugs or
biologicals
Hospital outpatient (Medicare)
CPT5
20610 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance Used to report knee injections without ultrasound guidance
Modifier5
RT Right side (used to identify procedures performed on the right side of the body Used to report injections in the right knee only
LT Left side (used to identify procedures performed on the left side of the body) Used to report injections in the left knee only
50 Bilateral procedure Used to report injections in both knees
Hospital Revenue Codes (for hospital use only)6
0636 Drugs requiring detailed coding
0510 Clinic visit (general)

When using Not-Otherwise-Classified (NOC) code J3490 (or C9399 for Medicare) to report the use of ZILRETTA, health plans may require additional information, including the name of the drug (both brand and generic), National Drug Code (NDC) number, strength of drug administered, and dose.

Sample Product-Identifying Information
Drug name ZILRETTA (triamcinolone acetonide extended-release injectable suspension)
11-digit NDCa 70801-0003-01
Drug strength and dose 32 mg triamcinolone acetonide ER
Route of administration Intra-articular injection
For more information on coding for ZILRETTA, refer to the Coding and Billing Guide.
  1. 11-digit NDC is derived from the 10-digit code for the ZILRETTA kit (70801-003-01). Keep in mind that many health plans require use of the 11-digit code.

CPT=Current Procedural Terminology; ER=extended release; HCPCS=Healthcare Common Procedure Coding System; ICD-10=International Classification of Diseases, 10th Revision.