NUCALA

Reimbursement Nucala

11/4/20151 min read

Accurate reimbursement and compliance for NUCALA® (mepolizumab) depend on proper billing and coding. Here are several important rules:
Code for HCPCS:
J2182: 1 mg injection of mepolizumab.
Billing Example: Report 100 units of J2182 for a dosage of 100 mg of NUCALA.
00173-0881-01: NUCALA 100 mg/mL single-dose vial is the National Drug Code (NDC).
CPT Codes for Administration: 96372: Intramuscular or subcutaneous injection for therapeutic, preventative, or diagnostic purposes.
Use: Suitable for administering NUCALA subcutaneously.

Diagnose Codes: The patient's condition should be reflected in the appropriate ICD-10-CM diagnosis codes. The following are typical codes linked to NUCALA therapy:
J82: Eosinophilia in the lungs, not else classified.
J45.50: Uncomplicated severe chronic asthma.
J45.51: Acute aggravation of severe chronic asthma.
J45.52: Status asthmaticus with severe chronic asthma.
Eosinophilia (D72.1).
CMS-1500 example Form of Claim:
For reference, a sample CMS-1500 claim form that shows a potential NUCALA coding scenario is provided. The proper fields to fill out for reporting NUCALA administration are shown in this sample.

Other Resources: Coding Quick Reference Guide: Offers comprehensive NUCALA coding details, including HCPCS and NDC codes.
MyNUCALA Support: Provides tools to help patients and medical professionals during the course of therapy.
Following these recommendations will make it easier to accurately bill and get paid for NUCALA therapy. Consult the specific requirements of each payer and keep abreast of any modifications to coding standards.