Code Description HCPCS . HCPCS Soliris REMS program and additional information are available by telephone: 1-888-SOLIRIS (1-888-765-4747) or at www.solirisrems.com. Soliris [package insert]. Upon approval of Soliris, we started to question what would be the potential total cost of this therapy on a monthly basis and what should a plan potentially expect in PMPM spend due to utilization. Feb 24, 2012 #1 This is classified as a monoclonal antibody (no LCD available). 617–618, 1991) or from the Medical Advisory Committee of the Neuropathy Association (J Peripheral Nervous Assn., 2003, 8:282–284). Enrollment in the Soliris REMS program and additional information are available by telephone: 1-888-SOLIRIS (1-888-765-4747) or at www.solirisrems.com. Soliris is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS). SOLIRIS® (eculizumab) J Code: J1300 Drug Order: o PNH _____ # Refills (Recommend 15) o Initial Dose Infuse 600 mg IV weekly for 4 weeks, followed by 900 mg IV the following week and then DA: 20 PA: 71 MOZ Rank: 42 Listing of a code in this policy does not imply that the service described by the code is a covered or non- covered health service. SOLIRIS is only available through a program called the SOLIRIS REMS. HCPCS code C9399, Unclassified drug or biological, should be used for new drugs and biologicals that are approved by FDA on or after January 1, 2004, for which a specific HCPCS code has not been assigned. The patient has unequivocal CIDP as defined by the mandatory clinical and physiologic or pathologic criteria of the American Academy of Neurology (Neurology 41: pp. RxPA. Under the Soliris REMS, prescribers must enroll in the program. Event. The wholesale acquisition cost of Soliris is $6,522.90 for a 300mg vial as of September 2017, which translates to a HCPCS price of $217.43. J1300 Injection, eculizumab (Soliris®), 10 mg J1303 Injection, ravulizumab-cwvz, (Ultomiris®) 10 mg (new code effective 10/1/19) Note: CPT codes, descriptions and materials are copyrighted by the American Medical Association (AMA). VI. Under the Soliris REMS, prescribers must enroll in the program. Find-A-Code Tip. Soliris is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS). References 1. J1300-njection, I eculizumab, 10 mg C9052 Injection, ravulizumab-cwvz, 10 mg (ultomiris) J3590- Unclassified biologics (ultomiris) TYPE OF CRITERIA. Soliris® (eculizumab) (last updated 2/2019). Take advantage of the amazing tools in Find-A-Code to be more productive and show your worth. J-Code: ICD10: Will this medication be given concurrently with other agents? Eculizumab (Soliris) J1300. Thread starter traci.susong@gmail.com; Start date Feb 24, 2012; T. traci.susong@gmail.com Guru. Messages 161 Best answers 0. VI. J CODE. Laws, regulations, and policies concerning reimbursement are complex and are updated frequently. Coding and reimbursement. SOLIRIS may also increase the risk of other types of serious infections. Umsa is the Celgene Patient Support ® Specialist for Zip Code . Other drug or … Enrollment in the Soliris REMS program and additional information are available by telephone: 1-888-SOLIRIS (1-888-765-4747) or at www.solirisrems.com. RX.PA.069.E.MPC - Soliris (Eculizumab) PAGE NUMBER: 3 of 3 Codes: J Code(s) Code Description J1300 Injection, eculizumab, 10 mg REFERENCES 1. Demo Videos. Under the Soliris REMS, prescribers must enroll in the program. yes! References 1. References 1. Soliris® (Eculizumab) Page 3 of 9 UnitedHealthcare Oxford Clinical Policy Effective 02/01/2018 ©1996-2018, Oxford Health Plans, LLC Paroxysmal nocturnal hemoglobinuria (PNH)1 Soliris is medically necessary when all of the following criteria are met: Soliris is used to prevent the breakdown of red blood cells in adults with paroxysmal nocturnal hemoglobinuria (PNH). Enrollment in the Soliris REMS program and additional information are available by telephone: 1-888-SOLIRIS (1-888-765-4747) or at www.solirisrems.com. If your patient has already begun treatment with drug samples, please choose "new start of therapy". Drugs administered other than oral method, chemotherapy drugs J1438 is a valid 2021 HCPCS code for Injection, etanercept, 25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) or just “Etanercept injection” for short, used in Medical care.. J1438 has been in effect since 01/01/2000 Billing Code/Availability Information HCPCS code: J1300 – Injection, eculizumab, 10 mg; 1 billable unit = 10 mg NDC: Soliris 300 mg/30 mL single-use vials for injection: 25682-0001-xx VII. LAST P&T APPROVAL/VERSION Q3 2019 20190828C4867-A . JW Modifier JW Modifier effective January 1, 2017. Yes No If yes, please specify: Is this a new start or continuation of therapy**? J1300 . Soliris … Includes: indications, dosage, adverse reactions and pharmacology. Neumega official prescribing information for healthcare professionals. Soliris is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS). Brand Generic Code (NDC) HCPCS code SOLIRIS eculizumab one single-use vial with 300 mg 25682-001-01 . The Medicare Part B Drug and Biological Average Sales Price Quarterly Payment files for calendar year 2020 are located in the "Related Links" section below Enrollment in the Soliris REMS program and additional information are available by telephone: 1-888-SOLIRIS (1-888-765-4747) or at www.solirisrems.com. WellFirst Health Advantage - SOLIRIS (eculizumab) 4 of 5. Benefit coverage for any service is determined by the member’s policy of health coverage with the plan. Inclusion of a code in the table does not imply any right to reimbursement or guarantee claim payment. Boston, MA; Alexion Pharmaceuticals, Inc; … Alprostadil urethral suppository (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) J0278 Injection, amikacin sulfate, 100 mg J0280 Injection, aminophyllin, up to 250 mg J0282 … Benefit coverage for health services is determined by federal, state, or contractual requirements and applicable laws that may Billing Code/Availability Information HCPCS Code: J1303 − Injection, ravulizumab-cwvz, 10 mg; 1 billable unit = 10 mg NDC: Ultomiris 300 mg/3 mL single-use vials for injection: 25682-0025-xx HCPCS Drugs Administered Drugs Administered Other Than Oral Method. close. infusion of FFP * Doses should be administered at the above intervals, or within two days of these time points. Billing Code/Availability Information HCPCS code: J1300 – Injection, eculizumab, 10 mg; 1 billable unit = 10 mg NDC: Soliris 300 mg/30 mL single-use vials for injection: 25682-0001-xx VII. The fact that a drug, device, procedure, or service is assigned an HCPCS code and a payment rate does not imply coverage by the Medicare program, but indicates only how the product, procedure, or service may be paid if covered by the Medicare program. PRODUCTS AFFECTED: Soliris (eculizumab), Ultomiris (ravulizumab) DRUG CLASS: Complement Inhibitor . Soliris J Code Coupons, Promo Codes 09-2020 Hot www.goodinfohome.com. 6.0 NOTE: The use of physician samples or manufacturer discounts does not guarantee later coverage under the provisions of the medical certificate and/or pharmacy benefit. Under the Soliris REMS, prescribers must enroll in the program. If your child is treated with SOLIRIS, make sure that your child receives vaccinations against Streptococcus pneumoniae and Haemophilis influenzae type b (Hib). Soliris is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS). Soliris is also used to treat a rare chronic blood disease called atypical hemolytic uremic syndrome (aHUS) in adults and children who weigh at least 11 pounds (5 kilograms). Quickly review any new, revised, or deleted codes; See past Year Code Changes (by year) includes Code descriptions and Applicable Icons (e.g., HCC, Code First, ect.) PALYNZIQ ® (pegvaliase-pqpz) Injection is the first FDA-approved enzyme substitution therapy for adults with PKU (phenylketonuria) who have uncontrolled blood Phe (phenylalanine) levels above 600 micromol/L (10 mg/dL) on their current treatment. 1 INDICATIONS AND USAGE 1.1 Paroxysmal Nocturnal Hemoglobinuria (PNH) Soliris is indicated for the treatment of patients with paroxysmal nocturnal hemoglobinuria (PNH) to reduce hemolysis. In this section, you will find a quick reference to potentially applicable billing codes and resources for each Celgene product. *Note: for Soliris switch therapy please refer to the package insert for appropriate switch dosing. Billing Code/Availability Information Jcode: J1300 – Injection, eculizumab, 10 mg; 1 billable unit = 10 mg NDC: Soliris 300 mg/30 mL single-use vials for injection: 25682-0001-xx VII. Soliris [prescribing information]. View All Code Changes for the New Year. Eculizumab, sold under the brand name Soliris among others, is a medication used to treat paroxysmal nocturnal hemoglobinuria (PNH), atypical hemolytic uremic syndrome (aHUS), and neuromyelitis optica.In people with PNH, it reduces both the destruction of red blood cells and need for blood transfusion, but does not appear to affect the risk of death. To enroll in the Soliris REMS and order Soliris, please call 1.888. J1300 Injection, eculizumab, 10 mg. HCPCS Procedure & Supply Codes. Soliris J Code PNH aHUS Dosing and Administration. Is this your year to shine? Certain people may be at risk of serious infections with gonorrhea. If this is not your doctor's zip code, click the zip code link above. SOLIRIS (1.888. Do we need to use V58.12 and which chemo administration codes to use for this infusion. VI.