Name of the Procedure:

Injection, Hyaluronidase, up to 150 units (HCPCS Code: J3470)

• Common Name: Hyaluronidase Injection
• Technical/Medical Term: Hyaluronidase Enzyme Injection

Summary

Hyaluronidase injection involves administering a specific enzyme, hyaluronidase, which helps to break down hyaluronic acid in the body. This procedure typically facilitates the dispersion and absorption of subcutaneous fluids and medications.

Purpose

Medical Conditions or Problems Addressed:

• Edema (swelling) due to local anesthesia
• Extravasation of intravenous fluids or medicine
• Enhancing the effectiveness of other injected drugs
• Facilitating subcutaneous rehydration in patients

Goals or Expected Outcomes:

• Improved absorption of medications
• Reduced localized swelling and inflammation
• Enhanced efficacy of subcutaneously or intramuscularly administered drugs

Indications

Specific Symptoms or Conditions:

• Edematous states, particularly near injection sites
• Extravasation injury management
• Patients requiring enhanced drug absorption

Patient Criteria:

• Patients receiving subcutaneous or intramuscular medications
• Individuals experiencing localized swelling due to fluid retention or medication diffusion

Preparation

Pre-procedure Instructions:

• Patients may continue regular diet and medications unless instructed otherwise by a healthcare provider.
• Inform the provider of any allergies, particularly to hyaluronidase or other medications.
• Diagnostic tests are generally not required, but a thorough medical history and physical examination are conducted.

Procedure Description

Step-by-Step Process:

1. Assessment: Review patient history, current medications, and allergies.
2. Preparation: The injection site is cleaned with an antiseptic solution.
3. Administration:
   • Hyaluronidase is drawn into a syringe (up to 150 units per injection).
   • The medication is injected subcutaneously in the area requiring treatment.

Tools and Equipment:

• Sterile syringe and needle
• Antiseptic solution
• Hyaluronidase enzyme solution

Anesthesia or Sedation:

• Generally not required; a topical anesthetic may be used to minimize discomfort at the injection site.

Duration

The procedure typically takes about 15-30 minutes, including preparation and post-injection observation.

Setting

The injection is usually performed in an outpatient clinic, physician’s office, or hospital setting.

Personnel

Healthcare Professionals Involved:

• Physician (primary administrator)
• Nurse (assists with preparation and patient monitoring)

Risks and Complications

Common Risks:

• Mild pain or discomfort at the injection site
• Redness or swelling at the injection site

Rare Risks:

• Allergic reactions (rash, itching, difficulty breathing)
• Infection at the injection site

Management of Complications:

• Immediate medical attention for signs of severe allergic reactions
• Proper wound care and antibiotics if an infection occurs

Benefits

Expected Benefits:

• Enhanced absorption and effectiveness of medications
• Reduced localized swelling
• Quicker relief from symptoms related to swelling or poor medication absorption

Timeframe for Realization:

• Benefits are typically realized within hours to a few days post-injection.

Recovery

Post-procedure Care:

• Monitor the injection site for signs of infection or allergic reaction.
• Apply ice packs to reduce swelling or discomfort if necessary.

Expected Recovery Time:

• Most patients can resume normal activities immediately.
• Follow-up appointments as needed based on the underlying condition treated.

Alternatives

Other Treatment Options:

• Oral medications for edema
• Surgical drainage for severe fluid accumulation
• Alternate enzyme therapy

Pros and Cons of Alternatives:

• Oral medications: easier to administer but may act more slowly.
• Surgical drainage: more invasive but immediately effective in severe cases.
• Alternate enzyme therapy: effectiveness will vary depending on the specific enzymes used.

Patient Experience

During the Procedure:

• A mild prick or burning sensation at the injection site.

After the Procedure:

• Possible swelling or redness at the injection site, which usually resolves quickly.
• Pain management includes the use of over-the-counter pain relievers and applying ice packs for comfort.