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Reimbursement Information

This overview is intended solely for use as an informational tool to assist hospital billing staff with reimbursement issues. The coverage, coding, and payment information included in the overview is subject to change and should not be construed as legal advice. Providers should exercise independent clinical judgment when selecting codes and submitting claims to reflect accurately the services rendered to individual patients. Baxter Healthcare Corporation does not guarantee success in obtaining insurance payments. Third-party payment for medical products and services is affected by numerous factors, not all of which can be anticipated or resolved by Baxter Healthcare Corporation.

Reimbursement Hotline: 1-888-338-0001

hylenex recombinant (hyaluronidase human injection)—the first and only human recombinant has been approved by the US Food and Drug Administration (FDA) for the following indications:

  • as an adjuvant to increase the absorption and dispersion of other injected drugs;
  • for subcutaneous (SC) fluid administration; and
  • as an adjunct in SC urography for improving resorption of radiopaque agents.
  • The Centers for Medicare and Medicaid Services (CMS) have issued a unique HCPCS J-code for hylenex recombinant1:
    HCPCS
    Descriptor
    J3473
    Injection, hyaluronidase, recombinant, 1USP Unit
  • The appropriate CPT code for the administration of hylenex recombinant will depend on the actual service performed.
    CPT
    Descriptor
    96370
    SC infusion for therapy or prophylaxis (specify substance or drug); initial, up to one hour, including pump setup and establishment of SC infusion site(s)
    96371
    SC infusion for therapy or prophylaxis (specify substance or drug); additional pump setup with establishment of new SC infusion site(s)
    96372
    Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); SC or intramuscular
Important Risk Information for Healthcare Professionals
Indications

HYLENEX recombinant (hyaluronidase human injection) is indicated as an adjuvant to increase the absorption and dispersion of other injected drugs; for subcutaneous fluid administration; and as an adjunct in subcutaneous urography for improving resorption of radiopaque agents.

Important Risk Information
  • Hypersensitivity to hyaluronidase or any other ingredient in the formulation is a contraindication to the use of this product.
  • Discontinue HYLENEX recombinant (hyaluronidase human injection) if sensitization occurs.
  • Hyaluronidase should not be used to enhance the absorption and dispersion of dopamine and/or alpha agonist drugs.
  • Hyaluronidase should not be injected into or around an infected or acutely inflamed area because of the danger of spreading a localized infection.
  • Hyaluronidase should not be used to reduce the swelling of bites or stings.
  • Hyaluronidase should not be applied directly to the cornea.
  • Hyaluronidase should not be used for intravenous injections because the enzyme is rapidly inactivated.
  • Furosemide, the benzodiazepines and phenytoin have been found to be incompatible with hyaluronidase.
  • The most frequently reported adverse experiences have been mild local injection site reactions, such as erythema and pain.
  • Hyaluronidase has been reported to enhance the adverse events associated with co-administered drug products.
  • Allergic reactions (urticaria or angioedema) have been reported in less than 0.1% of patients receiving hyaluronidase.
  • Anaphylactic-like reactions following retrobulbar block or intravenous injections have occurred, rarely.
  • When hyaluronidase is added to a local anesthetic agent, it hastens the onset of analgesia and tends to reduce the swelling caused by local infiltration, but the wider spread of the local anesthetic solution increases its absorption; this shortens its duration of action and tends to increase the incidence of systemic reaction.
  • Edema has been reported most frequently in association with subcutaneous fluid administration.
  • The rate and volume of subcutaneous fluid administration should not exceed those employed for intravenous infusion. As with all parenteral fluid therapy, use the same precautions for restoring fluid and electrolyte balance.
  • During subcutaneous fluid administration, special care must be taken in pediatric patients to avoid over hydration by controlling the rate and total volume of the infusion.
  • When solutions devoid of inorganic electrolytes are given subcutaneously, hypovolemia may occur.