NULOJIX

For effective reimbursement and compliance, NULOJIX® (belatacept) billing and coding must be done correctly. Here are several important rules:
Code for HCPCS:
J0485: 1 mg injection of belatacept.
Billing Example: Report 250 units of J0485 for a dosage of NULOJIX of 250 mg.
Administration CPT Code: 96413: Administration of chemotherapy, intravenous infusion method; single or first substance/drug; up to 1 hour.
Usage: Since NULOJIX is categorized as a complicated biologic agent that needs such administration codes, it can be administered intravenously.
00003-0377-13: NULOJIX 250 mg single-use vial is the National Drug Code (NDC).

Diagnose Codes: The patient's condition should be reflected in the appropriate ICD-10-CM diagnosis codes. The following codes are frequently linked to NULOJIX therapy: Z94.0: Kidney transplant status.
Z48.22: Aftercare encounter after kidney transplant.
D82.3: Immunodeficiency as a result of a genetically faulty Epstein-Barr virus response.

Billing Considerations: JW Modifier: For biologicals and abandoned medications, include the JW modifier on Part B drug claims. In the patient's medical file, note how much NULOJIX was thrown away.
Location of Service: A doctor's office or an outpatient hospital setting that is equipped to handle immunosuppressive treatments is usually where NULOJIX is administered.
Documentation: Keep thorough medical records that include the diagnosis, treatment plan, dosage, administration route, and any medication waste. This paperwork helps with the processing of claims and shows medical necessity.
Following these recommendations will make it easier to accurately bill and get paid for NULOJIX therapy. Consult the specific requirements of each payer and keep abreast of any modifications to coding standards.