SYNVISC-ONE and SYNVISC Billing Codes
ICD-10-CM
M17.0	Bilateral primary osteoarthritis of knee
M17.10	Unilateral primary osteoarthritis, unspecified knee
M17.11	Unilateral primary osteoarthritis, right knee
M17.12	Unilateral primary osteoarthritis, left knee
M17.2	Bilateral post-traumatic osteoarthritis of knee
M17.30	Unilateral post-traumatic osteoarthritis, unspecified knee
M17.31	Unilateral post-traumatic osteoarthritis, right knee
M17.32	Unilateral post-traumatic osteoarthritis, left knee
M17.4	Other bilateral secondary osteoarthritis of knee
M17.5	Other unilateral secondary osteoarthritis of knee
M17.9	Osteoarthritis of knee, unspecified
NDC
58468-0090-01	SYNVISC
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

Notice: The above codes may be used to communicate services rendered when filing claims for SYNVISC and SYNVISC-ONE. These codes are being provided for informational purposes only and should be verified, as codes may change. The provision of billing codes does not constitute reimbursement or legal advice. It is not intended to substitute for the physician’s independent diagnosis or treatment of each patient.

Providers retain sole responsibility for determining reimbursement and insurance issues related to their patients and for ensuring the accuracy of their claim submissions. Sanofi cannot be responsible for failure of a provider to obtain reimbursement.

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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. Hypersensitivity reactions including anaphylactic reaction, anaphylactoid reaction, anaphylactic shock and angioedema have been reported for both SYNVISC and SYNVISC-ONE.

Do not concomitantly use disinfectants containing quaternary ammonium salts for skin preparation because hyaluronan can precipitate in their presence. Do not inject SYNVISC or SYNVISC-ONE extra-articularly, into the synovial tissues, into the fat pad or joint capsule, or intravascularly. Some cases of skin necrosis have been reported after intra-articular use of hyaluronic acid. Patients should be instructed to contact their treating physician if signs of skin disorder (such as change of color or open sores) appear. SYNVISC and SYNVISC-ONE are only intended for use by a healthcare professional adequately trained to administer intra-articular injections, according to standard medical practices.

The safety and efficacy of SYNVISC or SYNVISC-ONE in locations other than the knee, or for conditions other than osteoarthritis, or in combination with other intra-articular injectables, or in severely inflamed knee joints have not been established. Use caution when injecting SYNVISC or SYNVISC-ONE in patients allergic to avian proteins, feathers, or egg products; who have evidence of lymphatic or venous stasis in the leg to be treated; or who have severe inflammation in the knee to be treated. Remove any synovial fluid or effusion before injecting SYNVISC or SYNVISC-ONE. 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 (≤21 years old) or in pregnant or lactating women. Patients should be advised to avoid strenuous or prolonged weight-bearing activities for approximately 48 hours after treatment.

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 nonpharmacologic therapy and simple analgesics, e.g., acetaminophen.

For SYNVISC

In clinical trials, the most commonly reported adverse events were transient pain, swelling, and/or joint effusion in the injected knee. The following reported adverse events are among those that may occur in association with intra-articular injections, including SYNVISC: arthralgia, joint stiffness, joint effusion, joint swelling, joint warmth, injection site pain, arthritis, arthropathy, and gait disturbance.

For SYNVISC-ONE

The most commonly reported adverse events were arthralgia, arthritis, arthropathy, injection site pain, and joint effusion. The following reported adverse events are among those that may occur in association with intra-articular injections, including SYNVISC-ONE: arthralgia, joint stiffness, joint effusion, joint swelling, joint warmth, injection site pain, arthritis, arthropathy, and gait disturbance.

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Reimbursement Billing Codes for SYNVISC® (hylan G-F 20) and SYNVISC-ONE® (hylan G-F 20)

Did you know you can order SYNVISC/ SYNVISC-ONE at SanofiShoppe.com?

Specialty Pharmacy Forms

Important Safety Information

Indication

For SYNVISC

For SYNVISC-ONE

Important Safety Information

Indication

Reimbursement Billing Codes for SYNVISC^® (hylan G-F 20) and SYNVISC-ONE^® (hylan G-F 20)