DALVANCE

Adult and pediatric patients with acute bacterial skin and skin structure infections (ABSSSI) brought on by specific susceptible strains of Gram-positive bacteria can be treated with DALVANCE® (dalbavancin), an intravenous antibiotic.
Locator for Dalvan
Accurate reimbursement and compliance depend on proper billing and coding. A guide to help healthcare providers is provided below:
Details of the product:
Administration: Intravenous infusion is used to give oDALVANCE.
Dosage Forms: 500 mg of sterile powdered dalbavancin in single-dose vials.

Coding Information: HCPCS Code: oJ0875 - Injection, 5 mg of dalbavancin.
Billing Units: Indicate how many 5 mg doses were given. A 500 mg dose, for instance, ought to be billed as 100 units.
CPT Codes: 96365 Intravenous infusion, up to 1 hour initial, for diagnosis, prophylaxis, or therapy.
Billing Units: For the first hour of infusion, report one unit.
Each extra hour is denoted by o96366 (list individually in addition to the basic procedure code).
Billing Units: For every extra hour over the first, report one unit.

Codes for ICD-10-CM Diagnosis:
Choose the right code according to the patient's condition. Cellulitis, unidentified (L03.90) is one example.
L02.419: Unspecified hand cutaneous abscess.
L08.9: Unspecified local infection of the skin and subcutaneous tissue.

Sample Entries on the CMS-1500 Claim Form:
Enter the correct ICD-10-CM diagnosis code (for example, L03.90) 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 (96365) and the HCPCS code J0875 on a different line.
Locator 24E: Make use of Locator 21's diagnosis code.
Locator 24G: Show how many units were given (for example, 100 for a dosage of 500 mg).

Extra Points to Remember: ·NDC Reporting: Properly format the National Drug Code (NDC) and place it in the shaded section of Locator 24D.
Modifiers:
JW Modifier: If appropriate, use this to report any amount of drugs thrown.
JZ Modifier: Shows that no medication has been given to any patients or thrown away.
Payer Policies: As each payer may have different needs, confirm specific coding, coverage, and payment policies with them.
Refer to AbbVie's DALVANCE Coding & Billing Reference Guide for more details and resources.