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.
Billing Information - Billing on the medical benefit requires submission of a claim form using CPT code 90378 for Synagis®, with required NDC and billing units incremental to each 50 mg dose administered (i.e. 100 mg = 2 billing units).Oct 15, 2021
SYNAGIS, 50 mg and 100 mg for injection, is a prescription medication that is used to help prevent a serious lung disease caused by respiratory syncytial virus (RSV) in children: born prematurely (at or before 35 weeks) and who are 6 months of age or less at the beginning of RSV season.
Synagis (palivizumab), a monoclonal antibody, is used as a prophylaxis to reduce lower respiratory tract disease caused by RSV (respiratory syncytial virus) in premature, high-risk infants and children....Professional Claim Submission.Procedure CodeNDCNDC Description90378XXXXX-XXXX-02Synagis—50 mg1 more row
CPT® code 96372: Injection of drug/substance under skin or into muscle | American Medical Association.
Meloxicam Injection, for Intravenous Use (Anjeso™) HCPCS Code J3490: Billing Guidelines.Jun 16, 2020
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.
Synagis® (palivizumab) for infants is an FDA-approved prescription, made up of virus-fighting antibodies, which helps prevent serious respiratory tract infections caused by respiratory syncytial virus (RSV). While Synagis® is not a vaccine, it can help high-risk infants by protecting them from severe RSV disease.
Member meets either of the following criteria:Member's chronological age at the start of RSV season is less than 12 months; or.Member's chronological age at the start of RSV season is between 12 to 24 months and the member will be undergoing cardiac transplantation during the RSV season;
RSV codes: RSV-specific ICD-10 codes J12. 1, J20. 5, J21.Jun 17, 2019
Abstract. Respiratory syncytial virus (RSV) is the leading cause of hospitalizations in infants worldwide. Palivizumab, a humanized monoclonal antibody against the RSV F protein, is the only licensed agent for prevention of severe RSV infection in high-risk infants.May 1, 2021
Effective for dates of service on or after 10/19/2018 standard National Correct Coding Initiative (NCCI) Procedure to Procedure (PTP) editing will be applied to the administration code (CPT 96372) and Evaluation and Management (E/M) Service combination when rendered on the same date of service by the same provider.