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 OPDUALAG
Download
- Codes*
- Distribution
- FDA Letters
COPY
Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg
COPY
Drugs requiring detailed coding
COPY
Chemotherapy administration, IV
COPY
IV Therapy-General
COPY
Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug
Note:Payers require the submission of the 11-digit NDC on healthcare claim forms. Please use the 11-digit codes shown here.
COPY
A single-dose vial containing 240 mg of nivolumab and 80 mg of relatlimab per 20 mL (12 mg and 4 mg per mL) per carton
COPY
Malignant melanoma of skin
COPY
Malignant melanoma of lip
COPY
Malignant melanoma of eyelid, including canthus
COPY
Malignant melanoma of unspecified eyelid, including canthus
COPY
Malignant melanoma of right eyelid, including canthus
COPY
Malignant melanoma of right upper eyelid, including canthus
COPY
Malignant melanoma of right lower eyelid, including canthus
COPY
Malignant melanoma of left eyelid, including canthus
COPY
Malignant melanoma of left upper eyelid, including canthus
COPY
Malignant melanoma of left lower eyelid, including canthus
COPY
Malignant melanoma of ear and external auricular canal
COPY
Malignant melanoma of unspecified ear and external auricular canal
COPY
Malignant melanoma of right ear and external auricular canal
COPY
Malignant melanoma of left ear and external auricular canal
COPY
Malignant melanoma of other and unspecified parts of face
COPY
Malignant melanoma of unspecified part of face
COPY
Malignant melanoma of nose
COPY
Malignant melanoma of other parts of face
COPY
Malignant melanoma of scalp and neck
COPY
Malignant melanoma of trunk
COPY
Malignant melanoma of anal skin
COPY
Malignant melanoma of skin of breast
COPY
Malignant melanoma of other part of trunk
COPY
Malignant melanoma of upper limb, including shoulder
COPY
Malignant melanoma of unspecified upper limb, including shoulder
COPY
Malignant melanoma of right upper limb, including shoulder
COPY
Malignant melanoma of left upper limb, including shoulder
COPY
Malignant melanoma of lower limb, including hip
COPY
Malignant melanoma of unspecified lower limb, including hip
COPY
Malignant melanoma of right lower limb, including hip
COPY
Malignant melanoma of left lower limb, including hip
COPY
Malignant melanoma of overlapping sites of skin
COPY
Malignant melanoma of skin, unspecified
COPY
Malignant neoplasm of anus and anal canal
COPY
Malignant neoplasm of anus, unspecified
COPY
Malignant neoplasm of anal canal
COPY
Malignant neoplasm of vulva
COPY
Malignant neoplasm of labium majus
COPY
Malignant neoplasm of labium minus
COPY
Malignant neoplasm of clitoris
COPY
Malignant neoplasm of vulva, unspecified
COPY
Malignant neoplasm of vagina
COPY
Malignant neoplasm of other and unspecified female genital organs
COPY
Malignant neoplasm of other specified female genital organs
COPY
Malignant neoplasm of overlapping sites of female genital organs
COPY
Malignant neoplasm of female genital organ, unspecified
COPY
Malignant neoplasm of penis
COPY
Malignant neoplasm of prepuce
COPY
Malignant neoplasm of glans penis
COPY
Malignant neoplasm of overlapping sites of penis
COPY
Malignant neoplasm of penis, unspecified
COPY
Malignant neoplasm of other and unspecified male genital organs
COPY
Malignant neoplasm of epididymis
COPY
Malignant neoplasm of unspecified epididymis
COPY
Malignant neoplasm of right epididymis
COPY
Malignant neoplasm of left epididymis
COPY
Malignant neoplasm of spermatic cord
COPY
Malignant neoplasm of unspecified spermatic cord
COPY
Malignant neoplasm of right spermatic cord
COPY
Malignant neoplasm of left spermatic cord
COPY
Malignant neoplasm of scrotum
COPY
Malignant neoplasm of other specified male genital organs
COPY
Malignant neoplasm of overlapping sites of male genital organs
COPY
Malignant neoplasm of male genital organ, unspecified
COPY
Encounter for antineoplastic immunotherapy
Note: 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.
OPDUALAG may be purchased through the distributors listed below.
Physician Offices
Authorized Distributor | Phone Orders | Fax Orders and Website |
---|---|---|
Cardinal Health Specialty Pharmaceutical Distribution | 1-877-453-3972 | https://specialty online.cardinal health.com |
CuraScript Specialty Distribution | 1-877-599-7748 | https://www. curascriptsd. com |
McKesson Specialty Health | 1-800-482-6700 | https://mscs. mckesson.com |
Morris & Dickson Specialty | 1-800-710-6100 | Fax: 1-318-524-3096 https://www.mdspecialtydist.com |
Oncology Supply | 1-800-633-7555 | https://www. oncologysupply. com |
For offices that prefer to use the services of a specialty pharmacy, specialty pharmacies can obtain OPDUALAG from the distributors listed above.
Hospitals and Infusion Centers
Specialty Distributor | Phone Orders | Fax Orders and Website |
---|---|---|
ASD Healthcare | 1-800-746-6273 | Fax: 1-800-547-9413 https://www. asdhealthcare. com |
Cardinal Health Specialty Pharmaceutical Distribution | 1-866-677-4844 | Fax: 1-614-553-6301 https://order express.cardinal health.com |
DMS Pharmaceutical Group, Inc. | 1-877-788-1100 | Fax: 1-847-518-1105 https://www.dms pharma.com |
McKesson Plasma and Biologics | 1-877-625-2566 | Fax: 1-888-752-7626 https://connect. mckesson.com |
Puerto Rico Hospitals and Clinics
Authorized Distributor | Phone Orders | Fax Orders and Website |
---|---|---|
Cardinal Puerto Rico (Borschow) | 1-787-625-4200 | https://orderexpress.cardinalhealth.com |
Cesar Castillo, Inc. | 1-787-641-5242 (Hospitals) 1-787-641-5082 (Specialty Pharmacies) |
Fax: 1-787-999-1614 https://www.facilfarmaciacci.com |
Above information is accurate as of 08/22.
The OPDUALAG distribution program includes extended payment terms to Bristol Myers Squibb authorized OPDUALAG distributors. Healthcare providers and institutions should contact their OPDUALAG distributor to understand specific payment terms that may be available to them from their distributor.
Please see U.S. Full Prescribing Information for OPDUALAG.
FDA Approval Letter as Posted by the FDA:
OPDUALAG is indicated for the treatment of adult and pediatric patients 12 years of age or older with unresectable or metastatic melanoma – Approved on 03/18/2022
View LetterPlease see U.S. Full Prescribing Information for OPDUALAG.
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.