SYNVISC | Commonly Used Billing Codes

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.