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 ABRAXANE
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- Codes*
- Distribution
- FDA Letters
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Injection, paclitaxel protein-bound particles, 1 mg
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General pharmacy
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IV solutions; administration
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IV therapy (required by Medicare for separate billable drugs)
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Drugs requiring detailed coding; may be used to specify the drug given
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Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug
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100 mg of paclitaxel in a single-dose vial, individually packaged in a carton
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Malignant neoplasm of breast
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Malignant neoplasm of nipple and areola
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Malignant neoplasm of nipple and areola, female
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Malignant neoplasm of nipple and areola, right female breast
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Malignant neoplasm of nipple and areola, left female breast
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Malignant neoplasm of nipple and areola, unspecified female breast
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Malignant neoplasm of central portion of breast
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Malignant neoplasm of central portion of breast, female
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Malignant neoplasm of central portion of right female breast
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Malignant neoplasm of central portion of left female breast
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Malignant neoplasm of central portion of unspecified female breast
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Malignant neoplasm of upper-inner quadrant of breast
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Malignant neoplasm of upper-inner quadrant of breast, female
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Malignant neoplasm of upper-inner quadrant of right female breast
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Malignant neoplasm of upper-inner quadrant of left female breast
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Malignant neoplasm of upper-inner quadrant of unspecified female breast
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Malignant neoplasm of lower-inner quadrant of breast
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Malignant neoplasm of lower-inner quadrant of breast, female
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Malignant neoplasm of lower-inner quadrant of right female breast
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Malignant neoplasm of lower-inner quadrant of left female breast
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Malignant neoplasm of lower-inner quadrant of unspecified female breast
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Malignant neoplasm of upper-outer quadrant of breast
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Malignant neoplasm of upper-outer quadrant of breast, female
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Malignant neoplasm of upper-outer quadrant of right female breast
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Malignant neoplasm of upper-outer quadrant of left female breast
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Malignant neoplasm of upper-outer quadrant of unspecified female breast
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Malignant neoplasm of lower-outer quadrant of breast
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Malignant neoplasm of lower-outer quadrant of breast, female
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Malignant neoplasm of lower-outer quadrant of right female breast
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Malignant neoplasm of lower-outer quadrant of left female breast
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Malignant neoplasm of lower-outer quadrant of unspecified female breast
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Malignant neoplasm of axillary tail of breast
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Malignant neoplasm of axillary tail of breast, female
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Malignant neoplasm of axillary tail of right female breast
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Malignant neoplasm of axillary tail of left female breast
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Malignant neoplasm of axillary tail of unspecified female breast
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Malignant neoplasm of overlapping sites of breast
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Malignant neoplasm of overlapping sites of breast, female
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Malignant neoplasm of overlapping sites of right female breast
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Malignant neoplasm of overlapping sites of left female breast
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Malignant neoplasm of overlapping sites of unspecified female breast
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Malignant neoplasm of breast of unspecified site
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Malignant neoplasm of breast of unspecified site, female
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Malignant neoplasm of unspecified site of right female breast
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Malignant neoplasm of unspecified site of left female breast
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Malignant neoplasm of unspecified site of unspecified female breast
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Malignant neoplasm of nipple and areola, male
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Malignant neoplasm of nipple and areola, right male breast
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Malignant neoplasm of nipple and areola, left male breast
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Malignant neoplasm of nipple and areola, unspecified male breast
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Malignant neoplasm of central portion of breast
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Malignant neoplasm of central portion of breast, male
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Malignant neoplasm of central portion of right male breast
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Malignant neoplasm of central portion of left male breast
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Malignant neoplasm of central portion of unspecified male breast
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Malignant neoplasm of upper-inner quadrant of breast
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Malignant neoplasm of upper-inner quadrant of breast, male
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Malignant neoplasm of upper-inner quadrant of right male breast
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Malignant neoplasm of upper-inner quadrant of left male breast
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Malignant neoplasm of upper-inner quadrant of unspecified male breast
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Malignant neoplasm of lower-inner quadrant of breast
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Malignant neoplasm of lower-inner quadrant of breast, male
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Malignant neoplasm of lower-inner quadrant of right male breast
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Malignant neoplasm of lower-inner quadrant of left male breast
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Malignant neoplasm of lower-inner quadrant of unspecified male breast
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Malignant neoplasm of upper-outer quadrant of breast
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Malignant neoplasm of upper-outer quadrant of breast, male
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Malignant neoplasm of upper-outer quadrant of right male breast
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Malignant neoplasm of upper-outer quadrant of left male breast
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Malignant neoplasm of upper-outer quadrant of unspecified male breast
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Malignant neoplasm of lower-outer quadrant of breast
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Malignant neoplasm of lower-outer quadrant of breast, male
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Malignant neoplasm of lower-outer quadrant of right male breast
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Malignant neoplasm of lower-outer quadrant of left male breast
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Malignant neoplasm of lower-outer quadrant of unspecified male breast
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Malignant neoplasm of axillary tail of breast
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Malignant neoplasm of axillary tail of breast, male
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Malignant neoplasm of axillary tail of right male breast
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Malignant neoplasm of axillary tail of left male breast
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Malignant neoplasm of axillary tail of unspecified male breast
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Malignant neoplasm of overlapping sites of breast
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Malignant neoplasm of overlapping sites of breast, male
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Malignant neoplasm of overlapping sites of right male breast
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Malignant neoplasm of overlapping sites of left male breast
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Malignant neoplasm of overlapping sites of unspecified male breast
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Malignant neoplasm of breast of unspecified site
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Malignant neoplasm of breast of unspecified site, male
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Malignant neoplasm of unspecified site of right male breast
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Malignant neoplasm of unspecified site of left male breast
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Malignant neoplasm of unspecified site of unspecified male breast
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Malignant neoplasm of upper lobe, bronchus or lung
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Malignant neoplasm of upper lobe, unspecified bronchus or lung
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Malignant neoplasm of upper lobe, right bronchus or lung
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Malignant neoplasm of upper lobe, left bronchus or lung
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Malignant neoplasm of middle lobe, bronchus or lung
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Malignant neoplasm of lower lobe, bronchus or lung
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Malignant neoplasm of lower lobe, unspecified bronchus or lung
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Malignant neoplasm of lower lobe, right bronchus or lung
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Malignant neoplasm of lower lobe, left bronchus or lung
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Malignant neoplasm of overlapping sites of bronchus and lung
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Malignant neoplasm of overlapping sites of unspecified bronchus and lung
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Malignant neoplasm of overlapping sites of right bronchus and lung
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Malignant neoplasm of overlapping sites of left bronchus and lung
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Malignant neoplasm of unspecified part of bronchus or lung
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Malignant neoplasm of unspecified part of unspecified bronchus or lung
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Malignant neoplasm of unspecified part of right bronchus or lung
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Malignant neoplasm of unspecified part of left bronchus or lung
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Malignant neoplasm of pancreas
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Malignant neoplasm of head of pancreas
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Malignant neoplasm of body of pancreas
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Malignant neoplasm of tail of pancreas
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Malignant neoplasm of pancreatic duct
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Malignant neoplasm of endocrine pancreas
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Malignant neoplasm of other parts of pancreas
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Malignant neoplasm of overlapping sites of pancreas
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Malignant neoplasm of pancreas, unspecified
ABRAXANE may be purchased through the distributors listed below.
Specialty Distributor | Phone Orders | Fax Orders and Website |
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ASD Healthcare | 1-800-746-6273 | Fax: 1-800-547-9413 https://www.asd healthcare.com |
Cardinal Health Specialty Pharmaceutical Distribution | 1-877-453-3972 | https://specialty online.cardinal health.com |
CuraScript Specialty Distribution | 1-877-599-7748 | https://www.cura scriptsd.com |
McKesson Plasma and Biologics | 1-877-625-2566 | Fax: 1-888-752-7626 https://connect. mckesson.com |
McKesson Specialty | 1-800-482-6700 | https://mscs. mckesson.com |
Morris & Dickson Specialty | 1-800-710-6100 | Fax: 1-318-524-3096 https://www.mds pecialtydist.com |
Oncology Supply | 1-800-633-7555 | https://www. oncologysupply .com |
Wholesalers | Phone Orders | Fax Orders and Website |
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AmerisourceBergen Corporation | 1-844-222-2273 | https://abcorder. amerisource bergen.com |
Cardinal Health Inc. | 1-800-964-5227 | https://www.card inalhealth.com/ en/login.html |
DMS Pharmaceutical Group, Inc. | 1-877-788-1100 | Fax: 1-847-518-1105 https://www.dms pharma.com |
McKesson Corporation | 1-855-625-7385
(independent chain pharmacies) 1-855-625-6285 (retail account) 1-855-625-4677 (hospitals and health systems) |
https://connect. mckesson.com |
Morris & Dickson Co., LLC | 1-800-388-3833 | https://www.md webportal.net |
N.C. Mutual Wholesale Drug Co. | 1-800-800-8551 | https://orders. mutualdrug.com |
Smith Drug Company Div Jm Smith Corporation | 1-800-542-1216 | https://egate. smithdrug.com/ |
Puerto Rico Hospitals and Oncology Clinics
Authorized Distributor | Phone Orders | Fax Orders and Website |
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Cardinal Puerto Rico (Borschow) | 1-787-625-4200 | https://orderexpress.cardinalhealth.com |
Cesar Castillo Inc. | 1-787-641-5242 (Hospitals) 1-787-641-5082 (Specialty Pharmacies) |
Fax: 1-787-999-1614 https://www.facilfarmaciacci.com |
Above information is accurate as of 06/22.
The ABRAXANE distribution program includes extended payment terms to Bristol Myers Squibb authorized ABRAXANE distributors. Healthcare providers and institutions should contact their ABRAXANE distributor to understand specific payment terms that may be available to them from their distributor.
Please see U.S. Full Prescribing Information for ABRAXANE, including Boxed WARNING.
FDA Approval Letters as Posted by the FDA:
For the treatment of metastatic breast cancer after failure of combination chemotherapy for metastatic disease or relapse within 6 months of adjuvant chemotherapy. Prior therapy should have included an anthracycline unless
clinically contraindicated
View Letter
For the first-line treatment of locally advanced or metastatic non–small cell lung cancer, in combination with carboplatin, in patients who are not candidates for curative surgery or radiation therapy
View Letter
For the first-line treatment of patients with metastatic adenocarcinoma of the pancreas, in combination with gemcitabine
View Letter
Please see U.S. Full Prescribing Information for ABRAXANE, including Boxed WARNING.
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.