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 Diagnostic Codes icon

Billing and
Diagnosis Codes

Hepatocellular Carcinoma (HCC)

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 OPDIVO

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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


Injection, nivolumab, 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 records.2

Revenue Codes (for Use in the Hospital Outpatient Setting)3


Drugs requiring detailed coding



Chemotherapy administration, IV



IV solutions

Current Procedural Terminology (CPT)4,†


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

National Drug Codes (NDC)5 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.



40 mg/4 mL (10 mg/mL) single-dose vial



100 mg/10 mL (10 mg/mL) single-dose vial



240 mg/24 mL (10 mg/mL) single-dose vial

International Classification of Diseases, Tenth Revision, Clinical Modification Diagnosis Codes (ICD-10-CM)6

Malignant neoplasm of liver and intrahepatic bile ducts


Liver cell carcinoma (hepatocellular carcinoma, hepatoma)



Malignant neoplasm of liver, primary, unspecified as to type



Encounter for antineoplastic immunotherapy 

If infusion for antineoplastic immunotherapy is the only reason for the patient encounter, physicians and hospitals may report ICD-10-CM code “Z51.12 Encounter for antineoplastic immunotherapy” as the primary diagnosis.

Coding for OPDIVO 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 OPDIVO.

*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 information 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 ©2018 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.


  1. American Medical Association. 2019 HCPCS Level II. Professional ed. Chicago, IL: American Medical Association; 2019.
  2. Centers for Medicare & Medicaid Services. MLN Matters, Number MM9603 . Revised June 10, 2016 Accessed January 11, 2018.
  3. Palmetto GBA. Medicare Part A Billing Guide. May 2017.$File/Part_A_Billing_Guide.pdf. Accessed January 11, 2018.
  4. American Medical Association. Current Procedural Terminology 2019. Professional ed. Chicago, IL: American Medical Association; 2018.
  5. OPDIVO [package insert]. Princeton, NJ: Bristol-Myers Squibb Company.
  6. American Medical Association. 2019 ICD-10-CM: The Complete Official Codebook. Chicago, IL: American Medical Association; 2018.

OPDIVO may be purchased through the distributors listed below.

Physician offices

Specialty Distributor Phone Orders Website
Cardinal Health Specialty Pharmaceutical Distribution 1-877-453-3972
7 AM-6 PM CT (24-hour emergency on call)
CuraScript Specialty Distribution 1-866-433-3589
8 AM-7 PM ET
McKesson Specialty Health 1-800-482-6700
7 AM-7 PM CT
Oncology Supply 1-800-633-7555
8 AM-7 PM CT

For offices that prefer to use the services of a specialty pharmacy, specialty pharmacies can obtain OPDIVO 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 AM-6:30 PM CT; Friday, 7 AM-6 PM CT (24-hour emergency on call) 1-800-547-9413
Cardinal Health Specialty Pharmaceutical Distribution 1-866-677-4844
7 AM-6 PM CT (24-hour emergency on call)
DMS Pharmaceutical Group, Inc. 1-877-788-1100
8:30 AM-5 PM CT
McKesson Plasma and Biologics 1-877-625-2566
8 AM-6:30 PM CT
Smith Medical Partners 1-800-292-9653
8 AM-6 PM CT; Friday, 8 AM-4:30 PM CT

Above information is accurate as of 01/19.

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

Please see U.S. Full Prescribing Information for OPDIVO.

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 01/19.

1506US1704564-02-01 01/19