Coding for Synagis (palivizumab) differs from coding for vaccines and toxoids. Synagis is not considered a vaccine or toxoid but an immunoglobulin, so it cannot be coded with the same vaccine administration codes that most practices are familiar with (90465–90474). When a baby comes to your office for a Synagis injection, it is important to recognize a few key factors to determine the appropriate way to code the visit.

The Synagis serum is coded with 90378 (respiratory syncytial virus immune globulin, for intramuscular use [RSV-IgIM], 50 mg, each). The administration code for Synagis is 90772 (therapeutic, prophylactic, or diagnostic injection [specify drug or substance]; subcutaneous or intramuscular).

Code 90772 has a few guidelines to which you must adhere. The first is that if you are performing a significant, separately identifiable E/M service (eg, 99201–99215) as well as an injection to be coded with 90772, you must place modifier 25...

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