BRIUMVI
Reimbursement Briumvi
12/28/20221 min read


Adults with relapsing types of multiple sclerosis (MS), such as clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive illness, can be treated with the monoclonal antibody BRIUMVI® (ublituximab-xiiy). For proper reimbursement and compliance, accurate billing and coding are necessary. A guide to help healthcare providers is provided below:
Details of the product:
The NDC (National Drug Code) is o73150-0150-06.
Details of the Coding:
HCPCS Code: J2329: Injection, 1 mg of ublituximab-xiiy
Billing Units: Indicate how many milligrams were given. For instance, enter 150 units for a dose of 150 mg.
ICD-10-CM Multiple Sclerosis Diagnosis Code: G35 uhcprovider.com
CPT Codes:
96413:Administration of chemotherapy, intravenous infusion; up to one hour, single or first substance/drug
96415: Every extra hour (list separately, along with the primary procedure code)
Sample Entries on the CMS-1500 Claim Form:
Enter the correct ICD-10-CM diagnosis code (such as G35) in locator 21.
Locator 24A: Indicate the service date.
Enter the place of service code (e.g., 11 for office) in locator 24B.
Locator 24D: Write the relevant CPT code (96413) and the HCPCS code J2329 on a different line.
Locator 24E: Make use of Locator 21's diagnosis code.
Locator 24G: Show how many units were given (for example, 150 for a dosage of 150 mg).
Extra Points to Remember: ·NDC Reporting: Properly format the National Drug Code (NDC) and place it in the shaded section of Locator 24D.
JW Modifier: If relevant, report any amount of discarded medication using the JW modifier.
Payer Policies: As each payer may have different needs, confirm specific coding, coverage, and payment policies with them.
For comprehensive information and resources, consult to the BRIUMVI Billing and Coding Guide supplied by TG Therapeutics.