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 EMPLICITI
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- Codes*
- Distribution
- FDA Letters
Injection, elotuzumab, 1 mg
Providers and suppliers are required to report the JW modifier on Part B drug claims for discarded drugs and biologicals. Also, providers and suppliers must document the amount of discarded drugs or biologicals in Medicare beneficiaries’ medical records2
Drugs requiring detailed coding
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Chemotherapy administration, IV
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IV Therapy-General
Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug
Ambulatory Payment Classification (APC)5: 5695, Level V Drug Administration
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Each additional hour
• List separately in addition to code for primary procedure
• Use 96415 in conjunction with 96413
• Report 96415 for infusion intervals of greater than 30 minutes
beyond 1-hour increments
Ambulatory Payment Classification (APC)5: 5692, Level II Drug Administration
Note:Payers require the submission of the 11-digit NDC on healthcare claim forms. Please use the 11-digit codes shown here.
300-mg single-dose vial
400-mg single-dose vial
EMPLICITI may be purchased through the distributors listed below.
Physician Offices
Specialty Distributor | Phone Orders | Website |
---|---|---|
Cardinal Health Specialty Pharmaceutical Distribution | 1-877-453-3972 Monday-Friday, 7 AM-6 PM CT (24-hour emergency on call) |
https://specialtyonline.cardinalhealth.com |
CuraScript Specialty Distribution | 1-866-433-3589 Monday-Friday, 8 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-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 below-listed distributors.
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) |
1-614-553-6301 https://orderexpress.cardinalhealth.com |
DMS Pharmaceutical Group, Inc. | 1-877-788-1100 Monday-Friday, 8:30 AM-5 PM CT |
1-847-518-1105 www.dmspharma.com |
McKesson Plasma and Biologics | 1-877-625-2566 Monday-Friday, 8 AM-6:30 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 09/20.
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.
Please see U.S. Full Prescribing Information for EMPLICITI.
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.
FDA Approval Letters as Posted by the FDA:
FDA Letter — in combination with pomalidomide and dexamethasone for the treatment of adult patients with multiple myeloma after at least two prior therapies including lenalidomide and a proteasome inhibitor
View Letter
FDA Letter — in combination with lenalidomide and dexamethasone for the treatment of adult patients with multiple myeloma after one to three prior therapies
View Letter
Please see U.S. Full Prescribing Information for EMPLICITI.
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.