Pediatric Coding Alert
Look to 96372 for Synagis Injection
Question: Our nurse administered a Synagis injection to a premature baby during a well child visit. Is this bundled into the E/M service or can we report it separately?
Answer: In this situation, you’ll report the appropriate preventive medicine code with modifier 25 appended, along with 96372 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular) to complete the claim.
Link your Synagis diagnosis to 765.10 (Prematurity), and link the preventive visit code to V20.2.
Don’t forget: If you are paying for the Synagis, you should also bill for the product. Report 90378 (Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each).
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