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.

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 INREBIC
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Type a keyword to find a specific HCPCS, NDC, or ICD-10 code
Healthcare Common Procedure Coding System (HCPCS) Codes1 Issued by CMS
J8999

Prescription drug, oral, chemotherapeutic, NOS

National Drug Codes (NDC)2Issued by the FDA

Note:Payers require the submission of the 11-digit NDC on healthcare claim forms. Please use the 11-digit codes shown here.

59572-0720-12

COPY

100 mg/capsule, bottle of 120 reddish brown, opaque size 0 capsules, printed with “FEDR 100 mg” in white ink

International Classification of Diseases, Tenth Revision, Clinical Modification Diagnosis Codes (ICD-10-CM)3

D47.4

COPY

Osteomyelofibrosis

D75.81

COPY

Myelofibrosis

INREBIC may be purchased through the distributors listed below.

Physician Offices

Specialty Distributor Phone and Fax Website
Accredo Phone: 1-877-732-3431
Fax: 1-888-302-1028
https://accredo.com
AllianceRx Walgreens Prime Phone: 1-888-347-3416
Fax: 1-877-231-8302
https://www.alliancerxwp.com
Amber Pharmacy Phone: 1-888-370-1724
Fax: 1-877-645-7514
https://amberpharmacy.com
Avella Specialty Pharmacy Phone: 1-877-546-5779
Fax: 1-877-546-5780
https://www.avella.com
Biologics Inc. Phone: 1-800-850-4306
Fax: 1-800-823-4506
https://www.biologicsinc.com
CVS Specialty Pharmacy Phone: 1-866-388-7656
Fax: 1-855-296-0210
https://www.cvsspecialty.com/wps/portal/specialty
Diplomat Phone: 1-877-977-9118
Fax: 1-800-550-6272
https://www.diplomatpharmacy.com/how-to-prescribe#oncology
Humana Phone: 1-800-486-2668
Fax: 1-877-405-7940
https://www.humanapharmacy.com/specialty
Onco360 Phone: 1-877-662-6633
Fax: 1-877-662-6355
https://www.onco360.com
Optum Specialty Pharmacy Phone: 1-855-427-4682
Fax: 1-877-342-4596
https://www.briovarx.com
US Bioservices Phone: 1-877-757-0667
Fax: 1-888-899-0067
https://www.usbioservices.com

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

Community Practices

Authorized Distributor Phone Fax
Cardinal Specialty Distribution Customers 1-877-453-3972 N/A
McKesson Specialty Health 1-800-482-6700
1-800-289-9285
Oncology Supply 1-800-633-7555
1-800-248-8205

Institutions/Hospitals

Authorized Distributor Phone Orders Fax Orders
AmerisourceBergen 1-844-222-2273 1-888-292-9774
ASD Healthcare 1-800-746-6273
1-800-547-9413
Cardinal Full Line Wholesale Customers 1-800-926-3161
N/A
Cardinal Specialty Distribution Customers 1-866-677-4844
N/A
McKesson Pharma 1-855-625-6285
1-800-599-9893

Puerto Rico Hospitals and Oncology Clinics

Authorized Distributor Phone and Fax Orders Website
Cardinal Puerto Rico (Borschow) Phone: 1-787-625-4200
Fax: N/A
https://orderexpress.
cardinalhealth.com
Cesar Castillo Inc. Phone: 1-787-641-5242 (Hospitals)
Phone: 1-787-641-5028 (Specialty Pharmacy)
Fax: 1-787-999-1614
https://www.facilfarmaciacci.com

Above information is accurate as of 04/21.

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

Please see U.S. Full Prescribing Information for INREBIC, including Boxed WARNING.

FDA Approval Letter as Posted by the FDA:

For the treatment of adult patients with intermediate-2 or high-risk primary or secondary (post-polycythemia vera or post-essential thrombocythemia) myelofibrosis (MF)
View Letter

Please see U.S. Full Prescribing Information for INREBIC, including Boxed WARNING.

Coding for INREBIC is dependent on the insurer and the care setting in which the drug will be administered. Oncology practices need to make coding decisions based on the diagnosis and treatment of each patient and the specific insurer requirements.

Please see U.S. Full Prescribing Information for INREBIC, including Boxed WARNING.

*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. All of the coding information presented by this website is applicable to outpatient procedures only.

References:

  1. American Medical Association. 2020 HCPCS Level II. Professional ed. Chicago, IL: American Medical Association; 2020.
  2. INREBIC [package insert]. Princeton, NJ: Bristol-Myers Squibb Company.
  3. Centers for Medicare & Medicaid Services. ICD-10-CM tabular list of diseases and injuries. Accessed March 8, 2021.
    https://www.cms.gov/Medicare/Coding/ICD10/2020-ICD-10-CM.

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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©2021 Bristol-Myers Squibb Company. All rights reserved. Access Support is a registered trademark of Bristol-Myers Squibb Company. INREBIC® is a trademark of Impact Biomedicines, Inc.

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 04/21.

2010-US-2100024 04/21