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How do you bill for Synagis injection?

by Chase Collins

How do you bill for Synagis injection?

Administration charges for the injection should be billed directly to Coordinated Care on a (HCFA) CMS 1500 claim form using CPT code 96372 (Administration) and CPT code 90378 (Medicine). You can also bill for an appropriate office visit for each administration of the drug.

What is the J code for Synagis?

The administration code for Synagis is 90772 (therapeutic, prophylactic, or diagnostic injection [specify drug or substance]; subcutaneous or intramuscular).

Who is eligible for the vaccine Synagis?

How does SYNAGIS help? SYNAGIS gives babies who are born prematurely (at or before 35 weeks, and who are 6 months of age or less at the beginning of RSV season) the infection-fighting antibodies they lack, helping protect their vulnerable lungs from RSV.

When do you use CPT 96372?

CPT code 96372 is used for certain types of vaccinations. Most vaccinations are typically coded with 90471 or 90472. Medicare uses G0008 as the administration code for flu vaccinations. Procedure code 96372 is billed for injections related to the provision of chemotherapy services.

What are the side effects of Synagis?

Common side effects of Synagis include:

  • diarrhea,
  • vomiting,
  • fever,
  • cough,
  • earache,
  • runny or stuffy nose,
  • sneezing,
  • other cold symptoms,

What are the side effects of SYNAGIS?

How effective is SYNAGIS?

Palivizumab is an RSV-specific monoclonal antibody licensed for the prevention of serious lower respiratory tract infection (LRTI) caused by RSV in high-risk children. Several prospective clinical trials have demonstrated an efficacy of 45%–82% against RSV-related hospitalizations in high-risk infants.

When do you use Synagis?

Synagis is used to prevent serious lung disease caused by respiratory syncytial virus in premature infants, and infants born with certain lung disorders or heart disease. Synagis works best in children who are 24 months old or younger at the beginning of RSV season (6 months or younger for premature infants).

Can you bill CPT 96372 with an office visit?

If you administer an injection in your office, e.g., naltrexone extended-release (Vivitrol®) or depot antipsychotics, you can bill for the administration of the injection separately from the billing for the visit itself. The CPT code 96372 should be used–Therapeutic, prophylactic, or diagnostic injection.

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How do you bill for SYNAGIS injection?

by Chase Collins

How do you bill for SYNAGIS injection?

Administration charges for the injection should be billed directly to Coordinated Care on a (HCFA) CMS 1500 claim form using CPT code 96372 (Administration) and CPT code 90378 (Medicine). You can also bill for an appropriate office visit for each administration of the drug.

Who is eligible for the vaccine SYNAGIS?

How does SYNAGIS help? SYNAGIS gives babies who are born prematurely (at or before 35 weeks, and who are 6 months of age or less at the beginning of RSV season) the infection-fighting antibodies they lack, helping protect their vulnerable lungs from RSV.

What is procedure code 90378?

Prescribers and pharmacy providers are required to indicate CPT (Current Procedural Terminology) procedure code 90378 (Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each) and the appropriate unit(s) on each claim.

What CPT code replaced 90772?

CPT code 90772 replaces codes 90782 and 90788, which were previously used to report subcutaneous or intramuscular administration of a therapeutic drug or antibiotic, respectively. You cannot report code 90772 for injections given without direct physician supervision.

What is the code for Synagis?

The Synagis serum is coded with 90378 (respiratory syncytial virus immune globulin, for intramuscular use [RSV-IgIM], 50 mg, each). The administration code for Synagis is 90772 (therapeutic, prophylactic, or diagnostic injection [specify drug or substance]; subcutaneous or intramuscular).

How many doses of Synagis are given?

Only administer one dose per vial. The efficacy of SYNAGIS at doses less than 15 mg/kg, or of dosing less frequently than monthly throughout the RSV season, has not been established.

Can Synagis be given at home?

How is it given? Synagis is given by injection (shot) into the leg muscle once a month for up to 5 months starting in November through March. It is usually given at the doctor’s office or at home by a nurse.

Why is Synagis so expensive?

Alex Zukiwski, chief medical officer of MedImmune, which was acquired last year by AstraZeneca PLC, says the Synagis price reflects the complexity of developing and manufacturing biological products, as well as the company’s commitment to RSV prevention and development of a vaccine.

What is the CPT code 90460?

The pediatric immunization administration with counseling codes are: 90460: Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered.

What does CPT code 90792 mean?

Psychiatric Diagnosis Interview Examination
CPT Code 90792 description: Psychiatric Diagnosis Interview Examination (PDE) performed by a licensed mental health provider. Elicitation of complete medical and psychiatric history (including past, family, social) Mental status examination.

What CPT code replaced 90782?

G0351
CPT codes 90783 and 90788 remain in effect. For 2005, 90782 is replaced by G0351, “Therapeutic or diagnostic injection (specify substance or drug); subcutaneous or intramuscular”.

How expensive is Synagis?

under the brand name Synagis, can cost up to $6,000 for five treatments, given to at-risk children in monthly intramuscular injections during RSV season. The company is pushing for wider use, but researchers are divided over its benefits and over when and to whom it should be administered.