Pediatric Coding Alert

Question: How can I streamline the process of preauthorizing Synagis?

Texas Subscriber

 
Answer: Synagis (CPT 90378 , Respiratory syncytial virus immune globulin [RSV-IgIM], for intramuscular use, 50 mg, each) costs $1,000 a month and must be taken for six months. Although the drug is expensive, insurance companies will pay for it because it reduces hospitalizations. But they require preauthorization, and the time spent obtaining this is not billable. To cut down on the work involved, obtain the preauthorization in writing, rather than over the telephone.