OMVOH

A monoclonal antibody called OMVOHTM (mirikizumab-mrkz) is authorized to treat individuals with moderately to severely active ulcerative colitis. For proper reimbursement and compliance, accurate billing and coding are necessary. A guide to help healthcare providers is provided below:
Details of the product:
Routes for Administration:
For intravenous (IV) infusion, OMVOH is provided in a single-dose vial containing 300 mg/15 mL. Subcutaneous (SC) Injection: Two prefilled pens containing 100 mg/mL of OMVOH are provided for SC usage.

Details of the Coding:
Codes for HCPCS: oJ2267: Injection, 1 mg of mirikizumab-mrkz.
Billing Units: Indicate how many milligrams were given. Enter 300 units, for instance, for an IV dosage of 300 mg.
ICD-10-CM Codes for diagnosis:
Choose the right code according to the patient's condition. As an illustration, consider:
K51.90: Complication-free ulcerative colitis.

CPT Codes:
IV Infusion: 96365: Intravenous infusion, initially up to one hour, for diagnosis, prophylaxis, or therapy.
SC Injection: 96372: Intramuscular or subcutaneous injection used for therapeutic, preventative, or diagnostic purposes.

Sample Entries on the CMS-1500 Claim Form:
Locator 21: Type in the relevant ICD-10-CM diagnosis code (K51.90, for example).
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 or 96372) on a separate line plus the HCPCS code J2267.
Locator 24E: Make use of Locator 21's diagnosis code.
Location 24G: Show how many units were given (e.g., 300 for a dose of 300 mg).

Extra Points to Remember: ·NDC Reporting: Properly format the National Drug Code (NDC) and place it in the shaded section of Locator 24D.
JW Modifier: If relevant, report any amount of discarded medication using the JW modifier.
Policies for Payers: Check with individual payers to confirm precise coding, coverage, and payment policies, as each may have different needs.
For thorough details and resources, consult Eli Lilly and Company's OMVOH Billing and Coding Guide. To guarantee correct billing procedures, it is essential to keep abreast of payer-specific policies and any modifications to coding standards.