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.
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.
Healthcare Common Procedure Coding System (HCPCS) Codes1Issued by CMS
J0129
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Injection, abatacept, 10 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
Current Procedural Terminology (CPT)3,† Back to Top
Intravenous Use Only
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
Subcutaneous Injection Only
96372
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Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular
National Drug Codes (NDC)4 Back to TopIssued 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.
For patients with moderate to severe juvenile idiopathic arthritis (JIA), ORENCIA may be administered as an intravenous infusion (6 years of age and older) or a subcutaneous injection (2 years of age and older). Intravenous dosing has not been studied in patients younger than 6 years of age. The safety and efficacy of ORENCIA ClickJect autoinjector for subcutaneous injection has not been studied in patients under 18 years of age.
Intravenous Use Only
00003-2187-10
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250 mg in a 15-mL single-use vial, in a clamshell presentation
00003-2187-13
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250 mg in a 15-mL single-use vial, in a carton presentation
Subcutaneous Injection Only
00003-2814-11
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Pack of 4 syringes with a passive needle safety guard (50 mg/0.4 mL pre-filled syringe)
00003-2818-11
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Pack of 4 syringes with a passive needle safety guard (87.5 mg/0.7 mL pre-filled syringe)
00003-2188-11
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Pack of 4 syringes with a passive needle safety guard (125 mg/1 mL pre-filled syringe)
00003-2188-51
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Pack of 4 single-dose autoinjectors (125 mg/1 mL)
International Classification of Diseases, Tenth Revision, Clinical Modification Diagnosis Codes (ICD-10-CM)5
The EMPLICITI distribution program includes extended payment terms to Bristol-Myers Squibb authorized EMPLICITI distributors. Healthcare providers and institutions should contact their EMPLICITI distributor to understand specific payment terms that may be available to them from their distributor.
*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.
American Medical Association. 2019 HCPCS Level II. Professional ed. Chicago, IL: American Medical Association; 2018.
Centers for Medicare & Medicaid Services. MLN Matters, Number MM9603 Revised. https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9603.pdf. Revised June 10, 2016. Accessed June 14, 2017.
American Medical Association. Current Procedural Terminology 2019. Professional ed. Chicago, IL: American Medical Association; 2018.
American Medical Association. 2019 ICD-10-CM: The Complete Official Codebook. Chicago, IL: American Medical Association; 2018.
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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