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 NULOJIX
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Codes*
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Type a keyword to find a specific HCPCS, CPT, NDC, or ICD-10 code

Healthcare Common Procedure Coding System (HCPCS) Codes¹ Issued by CMS.

J0485

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Injection, belatacept, 1 mg

Current Procedural Terminology (CPT)^2,†

96413

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Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug

96365

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Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour

National Drug Codes (NDC)³ Issued 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.

00003-0371-13

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One 250-mg vial, single use; one 12-mL syringe

International Classification of Diseases, Tenth Revision, Clinical Modification Diagnosis Codes (ICD-10-CM)⁴

Z94.0

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Kidney transplant status

Please see U.S. Full Prescribing Information for NULOJIX, including Boxed WARNINGS.

NULOJIX may be purchased through the approved distributor listed below.

Wholesaler	Phone Orders	Fax Orders and Website
McKesson Plasma and Biologics	1-877-625-2566	https://connect.mckesson.com

Above information is accurate as of 04/22.

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

Please see U.S. Full Prescribing Information for NULOJIX, including Boxed WARNINGS.

*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.

^†CPT codes and descriptions only are ©2019 by American Medical Association (AMA). All rights reserved. The AMA assumes no liability for data contained or not contained herein. CPT is a registered trademark of the American Medical Association.

References:

American Medical Association. 2020 HCPCS Level II. Professional ed. Chicago, IL: American Medical Association; 2020.
American Medical Association. Current Procedural Terminology 2020. Professional ed. Chicago, IL: American Medical Association; 2019.
NULOJIX [package insert]. Princeton, NJ: Bristol-Myers Squibb Company.
Centers for Medicare & Medicaid Services. ICD-10-CM tabular list of diseases and injuries. https://www.cms.gov/Medicare/Coding/ICD10/2020-ICD-10-CM. Accessed January 6, 2022.

NULOJIX^® (belatacept)

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Billing and
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