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).
Billing and payment for pre-approved Synagis® administration, outside of the specialty pharmacy provider, requires submission of a claim form using the designated CPT 90378 for Synagis®, with a required NDC and entry of billing units incremental to each 50 mg dose administered (i.e. 100mg = 2 billing units).
SYNAGIS [si-nah-jis] helps protect babies from RSV through virus-fighting antibodies. SYNAGIS is not a vaccine—it's an injection given once a month throughout RSV season, which usually starts in the fall and continues into spring.
Synagis J Code We use both 90378 and J3490, based on our contract with the individual payors.
ICD-10 Code for Respiratory syncytial virus as the cause of diseases classified elsewhere- B97. 4- Codify by AAPC.
The Current Procedural Terminology (CPT®) code 90378 as maintained by American Medical Association, is a medical procedural code under the range - Immune Globulins, Serum or Recombinant Products.
Currently, there is no cure or vaccine for RSV – the medical world is limited to offering only supportive care, such as oxygen and fluids, for those with the illness.
Through the Respiratory Syncytial Virus Prophylaxis for High-Risk Infants Program, the Ministry of Health covers the full cost of the drug palivizumab used to prevent a serious lower respiratory tract infection caused by the Respiratory Syncytial Virus ( RSV ) in infants who are less than 2 years of age at the start of ...
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.
Chronic Lung Disease (CLD) of prematurity (defined as birth at less than 32 weeks 0 days gestation and requiring greater than 21 percent oxygen for at least 28 days after birth).
96372The Current Procedural Terminology (CPT) code 90772 has been deleted from available CPT codes and replaced with CPT code 96372. The description stays the same: “therapeutic, prophylactic, or diagnostic injection (specify material injected); subcutaneous or intramuscular.”
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.