Bristol-Myers Squibb is committed to helping appropriate patients get access to our medications by providing access and reimbursement support services.

This information is intended for U.S. healthcare professionals and/or healthcare professionals involved in healthcare reimbursement.

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SPRYCEL® (dasatinib)

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Billing and
Diagnosis Codes

The accurate completion of reimbursement- or coverage-related documentation is the responsibility of the healthcare provider and patient. Bristol-Myers Squibb and its agents make no guarantee regarding reimbursement for any service or item.

Reimbursement and Coding Guide for SPRYCEL

  • Codes*


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Type a keyword to find a specific NDC or ICD-10 code
National Drug Codes (NDC)1Issued by the FDA
0003-0527-11

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20 mg, 60 tablets per bottle

0003-0528-11

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50 mg, 60 tablets per bottle

0003-0524-11

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70 mg, 60 tablets per bottle

0003-0855-22

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80 mg, 30 tablets per bottle

0003-0852-22

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100 mg, 30 tablets per bottle

0003-0857-22

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140 mg, 30 tablets per bottle

International Classification of Diseases, Tenth Revision, Clinical Modification Diagnosis Codes (ICD-10-CM)2

C91

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Lymphoid leukemia

C91.0

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Acute lymphoblastic leukemia (ALL)

C91.00

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Acute lymphoblastic leukemia, not having achieved remission

C91.01

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Acute lymphoblastic leukemia, in remission

C91.02

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Acute lymphoblastic leukemia, in relapse

C92

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Myeloid leukemia

C92.1

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Chronic myeloid leukemia (CML), BCR/ABL-positive

C92.10

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Chronic myeloid leukemia, BCR/ABL-positive, not having achieved remission

C92.11

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Chronic myeloid leukemia, BCR/ABL-positive, in remission

C92.12

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Chronic myeloid leukemia, BCR/ABL-positive, in relapse

EMPLICITI may be purchased through the distributors listed below.

Physician offices

Specialty Distributor Phone Orders Website
Cardinal Health Specialty Pharmaceutical Distribution 1-866-677-4844 Monday-Friday, 7 AM-7 PM CT (24-hour emergency on call) https://specialtyonline.cardinalhealth.com
CuraScript Specialty Distribution 1-877-599-7748 Monday-Friday, 8:30 AM-7 PM ET https://www.curascriptsd.com
McKesson Specialty Health 1-800-482-6700 Monday-Friday, 7 AM-7 PM CT https://mscs.mckesson.com
Oncology Supply 1-800-633-7555 Monday-Thursday, 8 AM-7:30 PM CT; Friday, 8 AM-7 PM CT https://www.oncologysupply.com

For offices that prefer to use the services of a specialty pharmacy, specialty pharmacies can obtain EMPLICITI from the distributors listed above.

Hospitals and Infusion Centers

Specialty Distributor Phone Orders Fax Orders and Website
ASD Healthcare 1-800-746-6273 Monday-Thursday, 7:30 AM-6:30 PM CT; Friday 7 AM-6 PM CT (24-hour emergency on call) 1-800-547-9413 https://www.asdhealthcare.com
Cardinal Health Specialty Pharmaceutical Distribution 1-866-677-4844 Monday-Friday, 7 AM-6 PM CT (24-hour emergency on call) 1-888-345-4916 https://orderexpress.cardinalhealth.com
DMS Pharmaceutical Group, Inc. 1-877-788-1100 Monday-Friday, 8 AM-6 PM CT 1-847-518-1105 www.dmspharma.com
McKesson Plasma and Biologics 1-877-625-2566 Monday-Friday, 8 AM-6 PM CT 1-888-752-7626 https://connect.mckesson.com
Smith Medical Partners 1-800-292-9653 Monday-Thursday, 8 AM-6 PM CT; Friday, 8 AM-4:30 PM CT 1-630-227-9220 www.smpspecialty.com

Above information is accurate as of 04/16.

The EMPLICITI distribution program includes extended payment terms to Bristol-Myers Squibb authorized EMPLICITI distributors. Healthcare providers and institutions should contact their EMPLICITI distributor to understand specific payment terms that may be available to them from their distributor.

 
 
 

*Healthcare providers should code healthcare claims based upon the service that is rendered, the patient’s medical record, the coding requirements of each health insurer, and best coding practices. Coding guidance provided under this heading does not provide a guarantee of reimbursement and should be considered together with all applicable coding guidance and standards.

References:

  1. SPRYCEL [package insert]. Princeton, NJ: Bristol-Myers Squibb Company.
  2. American Medical Association. 2018 ICD-10-CM: The Complete Official Codebook. Chicago, IL: American Medical Association; 2017.

The accurate completion of reimbursement- or coverage-related documentation is the responsibility of the healthcare provider and patient. Bristol-Myers Squibb and its agents make no guarantee regarding reimbursement for any service or item.

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Use of the information on this site is subject to the terms of our Legal Notice and Privacy Statement. The coding, coverage, and payment information contained within this website is current as of 05/18.

729US1801034-01-01 05/18