Common Billing Codes

To obtain reimbursement for Synvisc-One^® and SYNVISC^® (hylan G-F 20), you must submit a property coded claim form. Below are the billing codes commonly used for Synvisc-One and SYNVISC and its administration.

Synvisc-One Billing Codes

ICD-9-CM
	715.16	Osteoarthritis, localized, primary, lower leg
	715.26	Osteoarthritis, localized, secondary, lower leg
	715.36	Osteoarthritis, localized, unspecified as to primary or secondary, lower leg
	715.96	Osteoarthritis, localized, unspecified whether generalized or localized, lower leg
NDC
	58468-0090-01	SYNVSIC
	58468-0090-03	Synvisc-One
HCPCS
	J7325	for Synvisc-One and SYNVISC, per 1mg
	Synvisc-One	48 in Units field of CMS-1500 Claim form or electronic equivalent
	SYNVISC	16 in Units field of CMS-1500 Claim form or electronic equivalent
CPT
	20610	Arthrocentesis, major joint or bursa * Include modifiers -RT, -LT or 50 (bilateral)
	99211 to 99215	Office visit for established patients
	99201 to 99205	New patient office or other outpatient visit
Revenue Codes (used in hospital setting only)
	R636	Drugs requiring detailed coding
	510	Clinic Visit

The proper use of medical billing codes is critical for ensuring that your patient’s claims are submitted correctly and represent services rendered. Claim forms should include:

What drugs or supplies were used
What procedures were done
What disease state was treated

Providers are responsible for the selection of appropriate codes depending on clinical diagnosis. Information in the above table provides a general framework for understanding possible coding alternatives. It should not be used as a substitute for a healthcare professional’s own judgment.

Providers retain responsibility for determining reimbursement and insurance issues related to their patients. Genzyme cannot be responsible for failure of a provider to obtain reimbursement.

Indication

SYNVISC^® (hylan G-F 20) and Synvisc-One^® (hylan G-F 20) are indicated for the treatment of pain in osteoarthritis (OA) of the knee in patients who have failed to respond adequately to conservative non pharmacologic therapy and simple analgesics, e.g., acetaminophen.

Important Safety Information

SYNVISC and Synvisc-One are contraindicated in patients with known hypersensitivity to hyaluronan products or patients with infections in or around the target knee. Use caution when injecting SYNVISC or Synvisc-One in patients allergic to avian proteins, feathers, or egg products; who have evidence of venous or lymphatic stasis in the leg to be treated; or who have severe inflammation in the knee to be treated.

Patients should be advised to avoid strenuous or prolonged weight-bearing activities for approximately 48 hours after treatment. Aspiration of any effusion prior to injection is highly recommended. Strict adherence to aseptic technique must be followed to avoid joint infection. The safety and effectiveness of SYNVISC and Synvisc-One have not been established in children or in pregnant or lactating women. It is unknown whether SYNVISC or Synvisc-One is excreted in human milk.

For SYNVISC
In clinical trials, the most commonly reported adverse events were transient local pain, swelling, and/or effusion in the injected knee. In some cases, these symptoms have been extensive. Other side effects such as rash have been reported rarely.

View the Complete Prescribing Information for SYNVISC (PDF)

For Synvisc-One
The most commonly reported related local adverse events were transient, mild-to-moderate arthralgia, arthritis, arthropathy, injection site pain and joint effusion. No serious adverse events were reported in clinical trials in knees injected with Synvisc-One. Serious local adverse events have been reported only rarely in post-marketing use. Repeat treatment did not affect the safety profile. In the pivotal clinical trial, there was one related systemic event of syncope. The most common systemic side effects irrespective of relationship to Synvisc-One were headache, back pain, nasopharyngitis and influenza. Systemic adverse event profiles were similar between patients in the Synvisc-One and Saline Control groups.

View the Complete Prescribing Information for Synvisc-One (PDF)