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Unique J-code

Coding Alert: For Dates of Service Effective January 1, 2010

Now Reimbursement Can be Streamlined

The Centers for Medicare & Medicaid Services (CMS) have issued a new HCPCS billing code for Synvisc-One® (hylan G-F 20) and SYNVISC® (hylan G-F 20).

  • J7325, hyaluronan or derivative, SYNVISC or Synvisc-One, for intra-articular injection, 1 mg.

For dates of service in 2009, you should continue to use

  • J-code: J7322 for SYNVISC
  • Miscellaneous J-code: J3490 for Synvisc-One

As of January 1, 2010

  • CMS will discontinue the HCPCS code J7322 for SYNVISC
  • Providers should no longer bill the miscellaneous code J3490 for Synvisc-One

Billing Instructions for 2010

Synvisc-One Jcode update 

The new HCPCS billing code J7325, for Synvisc-One and SYNVISC, is available at www.cms.hhs.gov.

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)