FASENRA

Patients with severe eosinophilic asthma who are 6 years of age or older can receive an add-on maintenance medication called Fasenra® (benralizumab). Adult patients with eosinophilic granulomatosis with polyangiitis (EGPA) can also be treated with it.
Accurate reimbursement and compliance depend on proper billing and coding. The main rules are as follows:
Codes for diagnosis:
ICD-10-CM Codes:
Pulmonary eosinophilia, not else classified (J82).
M30.1: Lung involvement in polyarteritis [Churg-Strauss].

Process Codes: HCPCS Code: oJ0517-Injection, 1 mg of benralizumab. One milligram of Fasenra is represented by each billable unit.
CPT® Codes:
96372: Subcutaneous or intramuscular injection for therapeutic, preventative, or diagnostic purposes (name substance or medicine).
96401: Nonhormonal antineoplastic chemotherapy administered intramuscularly or subcutaneously.
The particular clinical situation and payer guidelines will determine whether of 96372 and 96401 is best. To find the correct code, refer to the most recent CPT® manual and payer policies.

The National Drug Code (NDC) for Fasenra 30 mg/mL single-dose prefilled syringe is 00310-1730-30.
Fasenra Pen 30 mg/mL single-dose autoinjector (00310-1830-30).
For claims processing and payment, it is essential to include the right NDC.

Extra Billing Considerations: Site of Care: Fasenra can be given in a number of locations, such as hospitals and patients' homes. Make that the right codes are utilized and that the administrative site complies with payer standards.
Pre-Authorization: Prior authorization for Fasenra therapy is required by many insurance companies. Before starting treatment, make sure that all required approvals have been received.
Records: Keep comprehensive medical records that include the diagnosis of EGPA or severe eosinophilic asthma, the course of treatment, and information on dosage and administration. This paperwork enables efficient claims processing and substantiates medical necessity.
To obtain complete and current information, use AstraZeneca's Fasenra Coding Resource.
Following these recommendations will help ensure that Fasenra therapy is accurately billed and reimbursed.