OCREVUS

Accurate reimbursement and compliance for OCREVUS® (ocrelizumab) depend on proper billing and coding. Here are several important rules:
Code for HCPCS:
J2350: 1 mg injection of ocrelizumab.
Billing Example: Report 300 units of J2350 for a dosage of 300 mg of OCREVUS.
CPT Administration Codes:
Chemotherapy administration, intravenous infusion technique; single or first substance/drug; up to 1 hour. (96413).
Use: Suitable for the first hour of OCREVUS intravenous infusion.
In addition to the code for the primary procedure, 96415: Chemotherapy delivery and intravenous infusion technique; each additional hour.
Usage: After the initial hour of infusion, report for each extra hour.

G35 is the diagnosis code for multiple sclerosis.
The OCREVUS 300 mg/10 mL (30 mg/mL) solution in a single-dose vial is the National Drug Code (NDC): 50242-150-01.
Aspects of Billing:
medicine Wastage Reporting: When the entire single-dose vial is consumed, use the JZ modifier to indicate that no medicine was wasted. If there is waste, note how much was thrown away and use the JW modifier appropriately.
Location of Service: OCREVUS is usually given at a doctor's office that is prepared to handle infusion treatments or an outpatient hospital.
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.