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

Advanced or Metastatic Gastric or Gastroesophageal Junction or Esophageal Adenocarcinoma

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 Therapy-General

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



120 mg/12 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 esophagus


Malignant neoplasm of lower third of esophagus


Malignant neoplasm of stomach


Malignant neoplasm of cardia


Malignant neoplasm of fundus of stomach


Malignant neoplasm of body of stomach


Malignant neoplasm of pyloric antrum


Malignant neoplasm of pylorus


Malignant neoplasm of lesser curvature of stomach, unspecified


Malignant neoplasm of greater curvature of stomach, unspecified


Malignant neoplasm of overlapping sites of stomach


Malignant neoplasm of stomach, unspecified


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.

OPDIVO may be purchased through the distributors listed below.

Physician Offices

Specialty Distributor Phone Orders Fax Orders and Website
Besse Medical 1-888-711-5469
7 AM-11 PM ET
Cardinal Health Specialty Pharmaceutical Distribution 1-877-453-3972
7 AM-6 PM CT
(24-hour emergency on call)
CuraScript Specialty Distribution 1-877-599-7748
8 AM-7 PM ET
McKesson Specialty Health 1-800-482-6700
7 AM-7 PM CT
Morris & Dickson Specialty 1-800-710-6100
8 AM-6 PM CT
Fax: 1-318-524-3096
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
Fax: 1-800-547-9413
Cardinal Health Specialty Pharmaceutical Distribution 1-866-677-4844 Monday-Friday,
7 AM-6 PM CT
(24-hour emergency on call)
Fax: 1-614-553-6301
DMS Pharmaceutical Group, Inc. 1-877-788-1100
8:30 AM-5 PM CT
Fax: 1-847-518-1105
McKesson Plasma and Biologics 1-877-625-2566
8 AM-6:30 PM CT
Fax: 1-888-752-7626
Morris & Dickson Specialty 1-800-710-6100 Fax: 1-318-524-3096

Puerto Rico Hospitals and Clinics

Authorized Distributor Phone Orders Fax Orders and Website
AmerisourceBergen Puerto Rico 1-844-222-2273

Above information is accurate as of 11/21.

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.

FDA Approval Letters as Posted by the FDA:

OPDIVO, in combination with fluoropyrimidine- and platinum-containing chemotherapy, for the treatment of patients with advanced or metastatic gastric cancer, gastroesophageal junction cancer, and esophageal adenocarcinoma – Approved on 4/16/2021

View Letter

Availability of OPDIVO 120 mg vial – Approved on 08/27/2021

View Letter

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

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 ©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.


  1. American Medical Association. 2020 HCPCS Level II. Professional ed. Chicago, IL: American Medical Association; 2020.
  2. Centers for Medicare & Medicaid Services. MLN Matters, Number MM9603 Revised. Revised June 10, 2016. Accessed November 15, 2019.
  3. Palmetto GBA. Medicare Part A Billing Guide. May 2017. Part_A_Billing_Guide.pdf/$File/Part_A_Billing_Guide.pdf. Accessed October 10, 2019.
  4. American Medical Association. CPT Professional 2020. Professional ed. Chicago, IL: American Medical Association; 2019.
  5. OPDIVO [package insert]. Princeton, NJ: Bristol-Myers Squibb Company.
  6. Centers for Medicare & Medicaid Services. ICD-10-CM tabular list of diseases and injuries. Accessed September 1, 2021.

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 03/22.

1506-US-2101816 03/22