[PDF] Reimbursement and Coding OPDIVO® (nivolumab)





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Coding and Billing Units: PHYSICIAN OFFICE CMS-1500 FORM

Coding and Billing Units: PHYSICIAN OFFICE CMS-1500 FORM OPDIVO® (nivolumab) and ... Chicago IL: American Medical Association; 2016.



Opdivo® (nivolumab)

Opdivo 40 mg/4 mL single-dose vial: 2 vials per 14 days Billing Code/Availability Information. HCPCS Code: ... N Engl J Med 2016; 375:1823-1833.



Reimbursement and Coding OPDIVO® (nivolumab)

Healthcare Common Procedure Coding System (HCPCS) and. Revenue Codes for OPDIVO® (nivolumab) + YERVOY® (ipilimumab). Recommended HCPCS Code for OPDIVO1.



Opdivo® (nivolumab)

31 mai 2016 Updated on. 3/25/2016 with effective date 4/1/2016. Accessed May 2016. Appendix 1 – Covered Diagnosis Codes. ICD-10. ICD-10 Description.



FL 42 FL 43 FL 44 FL 80 Coding and Billing Units: OUTPATIENT

Accessed March 2 2016. 4. OPDIVO [package insert]. Princeton



Centers for Medicare & Medicaid Services (CMS) Healthcare

8 mai 2015 Request to establish a unique Level II HCPCS code to identify OPDIVO® (nivolumab). Applicant's suggested language: J9XXX - Injection ...



Opdivo® (nivolumab)

1 avr. 2020 Dates Reviewed: 03/2015 07/2015



Coding and Billing Units: PHYSICIAN OFFICE CMS-1500 FORM

Coding and Billing Units: PHYSICIAN OFFICE CMS-1500 FORM OPDIVO® (nivolumab)1 ... Chicago IL: American Medical Association; 2016.



Haute Autorité de santé

13 janv. 2016 www.has-sante.fr – N° SIRET : 110 000 445 00012 – code APE : 8411 Z ... maladie de la spécialité OPDIVO (nivolumab) dans le traitement du mé ...



PRODUCT MONOGRAPH INCLUDING PATIENT MEDICATION

18 août 2022 40 mg and 100 mg single-use vials. Antineoplastic. (Anatomical Therapeutic Chemical index code: L01XC17). Pr OPDIVO® indicated for:.

A DIGITAL REFERENCE GUIDE TOWelcome

Reimbursement & Coding

for OPDIVO (nivolumab)

Use the buttons on the far right to

this Guide.

Links will appear in this area below to

sub sections of each indication.

Please see

Important Safety Information

for OPDIVO and YERVOY (ipilimumab), and US Full Prescribing Information for

OPDIVO

and

YERVOY.

For reimbursement assistance, call BMS Access Support at

1-800-861-0048

, 8 www.BMSAccessSupport.com

1506-US-2300071 03/23 OPDIVO Reimbursement & Coding Digital

Reference Guide 2023

SELECT IMPORTANT SAFETY INFORMATION

Summary of Warnings and Precautions

OPDIVO and YERVOY are associated with the following Warnings and Precautions: severe and fatal immune-mediated adverse reactions including pneumonitis,

colitis, hepatitis and hepatotoxicity, endocrinopathies, nephritis with renal dysfunction, dermatologic adverse reactions, other immune-mediated adverse reactions;

infusion-related reactions; complications of allogeneic hematopoietic stem cell transplantation (HSCT); embryo-fetal toxicity; and increased mortality in patients

with multiple myeloma when OPDIVO is added to a thalidomide analogue and dexamethasone, which is not recommended outside of controlled clinical trials.

Introduction

Introduction

Use the buttons on the far right to

this Guide.

Links will appear in this area below to

sub sections of each indication.

What"s New

1.1Please see Important Safety Information for OPDIVO and YERVOY

(ipilimumab), and US Full Prescribing Information for

OPDIVO

and

YERVOY.

For reimbursement assistance, call BMS Access Support at

1-800-861-0048

, 8 www.BMSAccessSupport.com

Indications

(continued on next page)

Introduction

Introduction

Use the buttons on the far right to

this Guide.

Links will appear in this area below to

sub sections of each indication.

What"s New

1.2Please see Important Safety Information for OPDIVO and YERVOY

(ipilimumab), and US Full Prescribing Information for

OPDIVO

and

YERVOY.

For reimbursement assistance, call BMS Access Support at

1-800-861-0048

, 8 www.BMSAccessSupport.com

Indications (continued)

(continued on next page)

Introduction

Introduction

Use the buttons on the far right to

this Guide.

Links will appear in this area below to

sub sections of each indication.

What"s New

1.3Please see Important Safety Information for OPDIVO and YERVOY

(ipilimumab), and US Full Prescribing Information for

OPDIVO

and

YERVOY.

For reimbursement assistance, call BMS Access Support at

1-800-861-0048

, 8 www.BMSAccessSupport.com

Indications (continued)

(continued on next page)

Introduction

Introduction

Use the buttons on the far right to

this Guide.

Links will appear in this area below to

sub sections of each indication.

What"s New

1.4Please see Important Safety Information for OPDIVO and YERVOY

(ipilimumab), and US Full Prescribing Information for

OPDIVO

and

YERVOY.

For reimbursement assistance, call BMS Access Support at

1-800-861-0048

, 8 www.BMSAccessSupport.com

Indications (continued)

Summary of Warnings and Precautions

OPDIVO and YERVOY are associated with the following Warnings and Precautions: severe and fatal immune-mediated adverse reactions including pneumonitis,

colitis, hepatitis and hepatotoxicity, endocrinopathies, nephritis with renal dysfunction, dermatologic adverse reactions, other immune-mediated adverse reactions;

infusion-related reactions; complications of allogeneic hematopoietic stem cell transplantation (HSCT); embryo-fetal toxicity; and increased mortality in patients

with multiple myeloma when OPDIVO is added to a thalidomide analogue and dexamethasone, which is not recommended outside of controlled clinical trials.

1506-US-2300071 03/23 OPDIVO Reimbursement & Coding Digital

Reference Guide 2023

General Codes

General Codes

2.1Please see Important Safety Information for OPDIVO and YERVOY

(ipilimumab), and US Full Prescribing Information for

OPDIVO

and

YERVOY.

For reimbursement assistance, call BMS Access Support at

1-800-861-0048

, 8 www.BMSAccessSupport.com

Use the following claim formats when OPDIVO or OPDIVO + YERVOY is administered to patients on an outpatient basis and billed to health plans:

2 3 4 (for Use in the Hospital Outpatient Setting)

Description

˜ˢ˟ˢDrugs requiring detailed coding

˜˟˟ˡChemotherapy administration, IV

˜˞ˢ˜IV therapy

HCPCS CodeDescriptionBilling Units

HCPCS CodeDescriptionBilling Units

J9299Injection, nivolumab, 1 mg1 mg = 1 billing unit

OPDIVO

͖͗ AND YERVOY

(ipilimumab)

insurer, and the best coding practices. The accurate completion of reimbursement- or coverage-related documentation is the responsibility of the healthcare provider

General Codes

General Codes

2.2Please see Important Safety Information for OPDIVO and YERVOY

(ipilimumab), and US Full Prescribing Information for

OPDIVO

and

YERVOY.

For reimbursement assistance, call BMS Access Support at

1-800-861-0048

, 8 www.BMSAccessSupport.com

Description

˥ˢˠ˝˟Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug

Description

Chemotherapy administration, IV infusion; each additional hour (list separately in addition to code for primary procedure). (Report

Please contact the payer for additional coding information regarding OPDIVO and OPDIVO + YERVOY.

IV=intravenous.

OPDIVO

AND YERVOY

(ipilimumab)

The accurate completion of reimbursement- or coverage-related documentation is the responsibility of the healthcare provider and the patient.

General Codes

General Codes

2.3Please see Important Safety Information for OPDIVO and YERVOY

(ipilimumab), and US Full Prescribing Information for

OPDIVO

and

YERVOY.

For reimbursement assistance, call BMS Access Support at

1-800-861-0048

, 8 www.BMSAccessSupport.com single-use vial billable units

͞s͟

OPDIVO

͖͗AND YERVOY

(ipilimumab)

NDC Codes for OPDIVO

7

NDC Codes for YERVOY

8

Storage Information

solution in a single-dose vial single-use vial billable unitsˠ˜͋ˠ solution in a single-dose vial˝˞˜͋˝˞ solution in a single-dose vial˞ˠ˜͋˞ˠ solution in a single-dose vial

The accurate completion of reimbursement- or coverage-related documentation is the responsibility of the healthcare provider and the patient.

General Codes

General Codes

2.4Please see Important Safety Information for OPDIVO and YERVOY

(ipilimumab), and US Full Prescribing Information for

OPDIVO

and

YERVOY.

For reimbursement assistance, call BMS Access Support at

1-800-861-0048

, 8 www.BMSAccessSupport.com

OPDIVO

͖͗AND YERVOY

(ipilimumab) How Supplied11-Digit NDCĎNDC Basis of MeasurementSample NDC 5010 Format How Supplied11-Digit NDCĎNDC Basis of MeasurementSample NDC 5010 Format 9 9 determine the required format.

The accurate completion of reimbursement- or coverage-related documentation is the responsibility of the healthcare provider and the patient.

General Codes

General Codes

˞̾ˡPlease see Important Safety Information for OPDIVO and YERVOY (ipilimumab), and US Full Prescribing Information for

OPDIVO

and

YERVOY.

For reimbursement assistance, call BMS Access Support at

1-800-861-0048

, 8 www.BMSAccessSupport.com

insurer, and the best coding practices. The accurate completion of reimbursement- or coverage-related documentation is the responsibility of the healthcare provider

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