What qualifies you for 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.

Who is eligible for RSV vaccine?

Infants born at 32-35 weeks’ gestational age who are younger than 3 months chronologic age at the start of or during the RSV season and who either (a) attend child care or (2) have 1 or more siblings or other children younger than 5 years living permanently in the same household; prophylaxis should be provided only …

Who should receive palivizumab?

The American Academy of Pediatrics (AAP, 2014) recommends the following babies receive palivizumab (Synagis®): Infants born at less than 29 weeks of gestational age and who are less than 1 year old at the beginning of RSV season. Infants less than 1 year old who have a significant congenital heart disease (CHD)

Who should not receive Synagis?

Synagis should not be given to children who have previously had a severe allergic reaction to Synagis. Check with your healthcare provider if you have questions about whether your child should receive Synagis.

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)….Coding for Synagis (Online Exclusive)

Scenario
A 3-month-old comes in for her routine well check and a Synagis dose that her mother just picked up from the pharmacy.
90772	V04.82

Can adults get Synagis?

It’s so common that most children have been infected with the virus by age 2. Respiratory syncytial (sin-SISH-ul) virus can also infect adults. In adults and older, healthy children, RSV symptoms are mild and typically mimic the common cold.

Can adults get the RSV vaccine?

In the U.S., it is estimated that more than 177,000 older adults ≥65 years of age are hospitalized and 14,000 of them die each year due to RSV. There is no vaccine to prevent RSV and the medical community is limited to offering only supportive care for those with the illness.

Can Synagis be given with other vaccines?

However, palivizumab (Synagis), an immunoglobulin monoclonal antibody, can reduce the risk of hospitalization for RSV. The standard prophylactic dose is 15 mg/kg every 30 days during RSV season, for up to five doses. Palivizumab does not interfere with immunizations and can be administered at the same time as vaccines.

Can Synagis be given early?

For patients undergoing cardiopulmonary bypass, administer a dose of SYNAGIS as soon as possible after the procedure, even if sooner than a month from the previous dose.

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 J code J3490?

Famotidine Injection (Pepcid®) HCPCS Code J3490: Billing Guidelines. 1, 2020, the Medicaid and NC Health Choice programs cover famotidine injection (Pepcid®) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3490 – Unclassified drugs.

Why does RSV not have a vaccine?

There are several obstacles to the development of successful RSV vaccines, including the need to immunize very young infants, who may respond inadequately to vaccination; the existence of two antigenically distinct RSV groups, A and B; and the history of disease enhancement following administration of a formalin- …