RADICAVA

One drug licensed to treat amyotrophic lateral sclerosis (ALS) is Radicava® (edaravone). Correct coding and billing are necessary for both compliance and appropriate reimbursement. Key Radicava® billing and coding information is provided below:
HCPCS Code: J1301: 1 mg injection of edaravone
The National Drug Code (NDC) for the single-dose bag of rasava (30 mg/100 mL) is 70510-2171-xx.
Diagnosis Code for Amyotrophic Lateral Sclerosis in ICD-10-CM: G12.21

Administration Codes: Depending on the particulars of the administration process, the correct CPT code should be chosen for the intravenous administration of Radicava®. To find the correct code, refer to the most recent CPT coding guidelines.
The standard dosage and billing units for each infusion of Radicava® are 60 mg, which translates to 60 billing units under HCPCS code J1301.

The first cycle of treatment consists of daily dosing for 14 days in a row, followed by a 14-day break without drugs.
Subsequent Cycles: 10 days of daily dosage for 14 days, followed by a 14-day break without drugs.
Documentation Advice: Make sure the patient's medical records explicitly state that Radicava® medication is medically necessary and that ALS (G12.21) is the diagnosis.
Keep thorough records of every infusion, including dosage, dates of administration, and any negative reactions.

Healthcare providers can access extensive materials on the official Radicava® healthcare provider website, such as benefit investigation forms and treatment initiation checklists.
Following these billing and coding rules is essential for correct reimbursement and payer compliance.