Intraarticular injections of hyaluronan inj 033 billing and coding guidelines. Treatment of pain in osteoarthritis in knee in patients who have failed nonpharmacologic treatment and simple analgesics euflexxa, gelone, hyalgan, orthovisc, supartz, synvisc, synviscone or. Safety of repeated injections of sodium hyaluronate supartz for knee osteoarthritis. The two names hyaluronic acid and sodium hyaluronate are used interchangeably in the beauty industry, but they do have their differences. The absorbanceobtained with the testsolution is not greater. Effects of onetime and twotime intraarticular injection. Find patient medical information for sodium hyaluronate intraarticular on webmd including its uses, side effects and safety, interactions, pictures, warnings and user ratings. Get information on sodium hyaluronate intraarticular injection including uses, dosage details, medication sideeffects and drug interaction facts from cleveland clinic s health library.
Sodium hyaluronate injection update horizon blue cross. They received three weekly intraarticular injections of sodium hyaluronate 2 % and chondroitin sulfate 2 % in combination. Do not inject gelsyn into the knees of patients having. Press release global sodium hyaluronate injection market is expected to grow at a cagr of 20. Federal law restricts this drug to use by or on the order of a licensed veterinarian. Description euflexxa6 is a viscoelastic, sterile solution of highly purified, high molecular weight 2. Irritation where hyaluronate and derivatives injection knee is used. Global sodium hyaluronate injection market is expected to. Hyaluronate is similar to a substance that occurs naturally in joints and that helps joints work properly by acting like a lubricant and shock absorber. Nh medicaid ffs hyaluronic acid derivatives injection criteria. In 1986, sodium hyaluronate was used as an intraarticular injection to treat osteoarthritis of. Before using sodium hyaluronate, inform your doctor about your current list of medications, over the counter products e. Evidence of severe boneonbone osteoarthritis of the knee. How are hyaluronic acid or hyaluronate injections used to treat knee osteoarthritis.
As an injected treatment for osteoarthritis, it is only fdaapproved for osteoarthritis of the knee, not for other regions of the body. Sodium hyaluronate also known as hyaluronic acid or hyaluronan is a natural substance. Precautions remove joint effusion, if present, before injecting trivisc. Each patient will receive an injection of sodium hyaluronate or placebo in the symptomatic hip and will be followed up for three months. Intraarticular injections of sodium hyaluronate are proven and medically necessary. Warnings do not concomitantly use disinfectants containing quaternary ammonium salts for skin preparation because sodium hyaluronate can precipitate in their presence. Sodium hyaluronate jordan university of science and. This leaflet gives you some basic information about. The table below shows the fda approved sodium hyaluronate products and their respective fda labeled dosage per treatment course per joint. Intraarticular hyaluronate injection for knee osteoarthritis.
Hope, hype, and hard truths, published in the february issue of the archives. The natural sodium hyaluronate layer on the corneal endothelium is reduced during irrigation, but can be restored by exogenous sodium hyaluronate. The benefits of hyaluronate sodium for knee osteoarthritis. The first commercially sold sodium hyaluronate had been developed by endre alexander balazs under the brand name of healon, manufactured by pharmacia ab in sweden in 1980. Use caution when injecting hyalgan into patients who are allergic to avian proteins, feathers, and egg. Sodium hyaluronate is usually given once every week for 3 to 5 weeks. How are hyaluronic acid or hyaluronate injections used to. These are not all of the side effects that may occur. Sodium hyaluronate is used to treat knee pain caused by osteoarthritis.
Sodium hyaluronate injections action sports medicine. Hyaluronic acid, the conjugate acid of hyaluronate sodium, is extracted from the capsule of streptococcus spp. The idea of hyaluronate injections comes from the direct understanding that oa derives from excessive mechanical stress applying to osteochondral surfaces 1. Sodium hyaluronate, an allnatural watersoluble form of hyaluronic acid, works in a similar way, offering better skin penetration and stability. You should not receive a sodium hyaluronate injection if you have an infection in your knee or in the skin around your knee. Hyalgan is contraindicated in patients with known hypersensitivity to hyaluronate preparations or in cases of present infections or skin diseases in the area of the injection site.
Womac subscore a was assessed at 1, 3 and 6 months after the last injection. Effective january 1, 2018, horizon bcbsnj will change the way that we approve and consider claims for certain sodium hyaluronate injections as noted below. Sodium hyaluronate is similar to the fluid that surrounds the joints in your body. Aetna medicare form viscosupplementation injectable.
Diagnosisspecific criteria initial authorization sodium hyaluronate naive patients intraarticular injections of sodium hyaluronate are proven and medically necessary when all of the following are met. Hyaluronate sodium injection route before using mayo. Sodium hyaluronate is a polysaccharide made up of disaccharide units linked by glycosidic bonds. Sodium hyaluronate is usually given when other arthritis medications have not been effective.
A healthcare provider will give you this injection. Do not use trivisc if the package is opened or damaged. Sodium hyaluronate is injected directly into your knee joint. Answer knee osteoarthritis is a common condition that. The full mechanism on how these compounds work has not been fully understood, but it is believed that they stimulate the cells in the joints to produce joint fluid and thus provide lubrication and cushioning within the joint. Synojoynttm 1% sodium hyaluronate product information. Patients who have not received relief from other treatments such as pain killers, ice, or heat are optimal candidates to. Sodium hyaluronate occurs naturally on the corneal endothelium, bound to specific receptors. Before using hyalgan hyaluronate sodium injection route in deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. Sodium hyaluronate may also be used for purposes not listed in this medication guide.
Hyaluronic acid ha is a high molecular weight biopolysacharide, discovered in 1934, by karl meyer and his assistant, john palmer in the vitreous of bovine eyes. Two hundred patients with mild to moderate oa of the knee were randomized to receive five weekly intraarticular injections of sodium hyaluronate or placebo. Intraarticular injections of hyaluronan inj033 billing. Hyaluronate and derivatives injection knee information. Sodium hyaluronate hyaluronan intraarticular injection hyalgan, supartz, euflexxa, orthovisc is a prescription medication used to treat knee pain from osteoarthritis in patients who do not receive pain relief from simple pain medications like acetaminophen tylenol and others. It can be used in any joint in the body that is classified as synovial. Food and drug administration fda labeled indications. Adjuvant therapy, intraarticular sodium hyaluronate, have been addressed to decrease pain, improve quality of life, and possibly delay surgery up to the appropriate time.
This medicine is injected directly into the knee to relieve pain caused by osteoarthritis. The primary efficacy outcome was the change from baseline to week 25 in patients evaluation of pain using a 100mm visual analog scale vas during the 50foot walking test. Content each prefilled syringe of synojoynt contains. The added gain when using sodium hyaluronate is that it penetrates the skin more easily than hyaluronic acid.
It is present in the body wherever moisture is stored or lubrication between layers of tissue is required to eliminate friction. When the injections are administered bilaterally, list j7321, j7323 or j7324 in item 24 fao09 electronically with a 2 in the units field. Fda labeling durolane 1 injection hymovis 2 injections synvisc one 1. In this study, 32 intraarticular injections of sodium hyaluronate resulted in no observed side effects or adverse reactions. Swelling where hyaluronate and derivatives injection knee is used.
There is no specific information comparing use of hyaluronate in the elderly with the use in other age groups. The difference between hyaluronic acid and sodium hyaluronate. Hyaluronic acid also has medical uses in which it is injected into the body. There were no skin reactions in an immunogenicity test of sodium hyaluronate on humans. Recent advances in hyaluronic acid based therapy for osteoarthritis. Hcpcs code j7321, j7323, and j7324 are per dose codes.
Some health conditions may make you more susceptible to the sideeffects of the drug. Safety of repeated injections of sodium hyaluronate. This fluid acts as a lubricant and shock absorber for the joints. Trial and failure or contraindication to nonpharmacologic therapy e. Sodium hyaluronate an overview sciencedirect topics. This does not imply that one is better than the other, rather it indicates that cosmetic. Human studies have shown that intraarticular injection of sodium hyaluronate is a relatively safe approach. Gr687444 1219 medicare form viscosupplementation injectable medication precertification request. Hyaluronic acid derivatives injection criteria indications. Continuing authorization is for a single injection course once per joint for 6 months. In general, the development of hyaluronate sodium for knee osteoarthritis dates back to the early to mid 1990s. Intraarticular injections of sodium hyaluronate hyalgan.
Its use for shoulder, hip, and ankle osteoarthritis is being studied. Sodium hyaluronate has recently been introduced for use during cataract surgery. Federal law restricts this device to sale by or on the order of a physician or properly licensed practitioner. The efficacy study of sodium hyaluronate to treat symptomatic hip osteoarthritis. Legend injectable solution is pyrogen free, sterile and does not contain a preservative. Osteoarthritis occurs when the cartilage between joints are worn down which can lead to pain, stiffness, or swelling in the affected joint. It appears to have even greater advantage if an intraocular lens is to be inserted percival, 1981 when it can protect the endothelium from touch by the implant. We choose to use sodium hyaluronate in our products. Each injection has been shown to lower the pain in patients in some form, though hyaluronic acid treatments seem to be the safest and last the. A number of clinical trials of sodium hyaluronate treatment have been compared with conservative treatment, including oral medication, or intraarticular steroid injection. In 2000, there were 144 reported adverse reactions from medical injection use of hyaluronic acid out of a possible 262,000 uses.
For this medicine, the following should be considered. Sodium hyaluronate of defined molecular size for treating. Sodium hyaluronate, also referred to as hyaluronic acid ha or hyaluronan, is a viscoelastic substance that occurs naturally in synovial fluid and is thought to play an important role in lubricating, protecting, and maintaining the health of articular cartilage. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. Sodium hyaluronate is a watersoluble salt form of hyaluronic acid created by scientists to increase stability and lessen the likelihood of oxidization. Sodium hyaluronate side effects, dosage, interactions. Many medicines have not been studied specifically in older people. Hyaluronan injections are approved for several other conditions, including burns and ulcers. Ghosh department of biotechnology, cadila pharmaceuticals ltd, 342 nani kadi, kadi 382 715, india sodium hyaluronate has been widely used in the treatment of osteoarthritis of the knee. Sodium hyaluronate of defined molecular size for treating osteoarthritis dhimant p. However, the side effects of sodium hyaluronate injection in dogs have not been reported.
Hyaluronic acid is a naturally occurring biopolymer, which has important biological functions in bacteria and higher animals including humans. If you have questions about side effects, call your doctor. Intraarticular injections of sodium hyaluronate are proven andor medically necessary for treating pain due to osteoarthritis oa of the knee when administered according to u. Injection grade sodium hyaluronate is widely used for parenteral preparations including intraarticular and intraocular preparations, such as ovd, intraarticular injections, intradermal injections for aesthetic correction, antiadhesive products, etc. Sodium hyaluronate with nmmd 100120kda 50 mg 1 520 40 sodium hyaluronate with nmmd 120140kda 50 mg 1 520 40 sodium hyaluronate with nmmd 140160kda 50 mg 1 750 40 sodium hyaluronate with nmmd 160350da 50 mg 1 750 40 set sodium hyaluronate with nmmd 5110 kda 220 mg 1 950 40. Shake each testtube once again, and determine the absorbance 2. Hyalgan is administered by your health care provider as an intraarticular injection into the knee joint. Initial authorization sodium hyaluronate naive patients. Hyaluronate sodium injection route description and brand. Beginning with services to be provided on and after january 1. Do not inject synviscone in the knees of patients having knee joint infections or skin diseases or infections in the area of the injection site. Do not administer to patients with known hypersensitivity allergy to sodium hyaluronate preparations. Description gelone is a sterile, transparent, and viscoelastic hydrogel composed of crosslinked hyaluronate, a derivative of highly purified sodium hyaluronate hyaluronan extracted from chicken.
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