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 POMALYST
Download
- Codes*
- Distribution
- FDA Letters
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1 mg/1 capsule bottles of 21
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1 mg/1 capsule bottles of 100
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2 mg/1 capsule bottles of 21
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2 mg/1 capsule bottles of 100
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3 mg/1 capsule bottles of 21
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3 mg/1 capsule bottles of 100
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4 mg/1 capsule bottles of 21
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4 mg/1 capsule bottles of 100
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Multiple myeloma and malignant plasma cell neoplasms
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Multiple myeloma
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Multiple myeloma not having achieved remission
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Multiple myeloma in remission
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Multiple myeloma in relapse
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Kaposi’s sarcoma
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Kaposi’s sarcoma of skin
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Kaposi's sarcoma of soft tissue
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Kaposi's sarcoma of palate
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Kaposi's sarcoma of lymph nodes
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Kaposi's sarcoma of gastrointestinal sites
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Kaposi's sarcoma of lung
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Kaposi's sarcoma of unspecified lung
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Kaposi’s sarcoma of right lung
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Kaposi’s sarcoma of left lung
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Kaposi’s sarcoma of other sites
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Kaposi’s sarcoma, unspecified
Prescribers and pharmacies must be certified with the POMALYST REMS® program by enrolling and complying with the REMS requirements; pharmacies must only dispense to patients who are authorized to receive POMALYST. The REMS-Pharmacy Network list includes specialty pharmacies that are contracted to fill prescriptions for restricted distribution programs for Bristol Myers Squibb.
Specialty Pharmacies
Pharmacy | Phone | Fax |
---|---|---|
Absolute Pharmacy | 1-787-892-8700 | 1-787-496-1010 |
AcariaHealth Pharmacy | 1-866-458-9246 | 1-866-458-9245 |
Accredo Specialty Pharmacy | 1-877-732-3431 | 1-800-590-1021 |
ACS Advanced Care Scripts | 1-877-985-6337 | 1-866-679-7131 |
AllianceRx Walgreens Prime | 1-888-347-3416 | 1-877-231-8302 |
Amber Specialty Pharmacy | 1-888-370-1724 | 1-877-645-7514 |
Axium Healthcare Puerto Rico | 1-787-780-7200 | 1-800-546-2163 |
Biologics by McKesson | 1-800-850-4306 | 1-800-823-4506 |
Biomatrix | 1-888-662-6779 | 1-877-800-4790 |
BioPlus Specialty Pharmacy | 1-888-292-0744 | 1-800-269-5493 |
CareMed Specialty Pharmacy | 1-877-227-3405 | 1-877-542-2731 |
CVS Specialty | 1-800-237-2767 | 1-800-323-2445 |
Farmacia San Rafael | 1-787-724-3333 | 1-787-721-4165 |
Humana Specialty Pharmacy | 1-800-486-2668 | 1-877-405-7940 |
Kroger Specialty Pharmacy | 1-888-327-2962 | 1-888-315-3270 |
Magellan Rx Pharmacy (ICORE) | 1-866-554-2673 | 1-866-364-2673 |
Onco360 | 1-877-662-6633 | 1-877-662-6355 |
Optum Specialty Pharmacy | 1-877-445-6874 | 1-866-306-5231 |
RxCrossroads by McKesson (VA Dispensing) | 1-855-637-9433 | 1-855-637-9446 |
Special Care Pharmacy Services | 1-787-781-4585 | 1-787-783-2951 |
Upstate Pharmacy | 1-800-314-4655 | 1-800-314-7756 |
US Bioservices | 1-877-757-0667 | 1-888-899-0067 |
Above information is accurate as of 12/21.
The POMALYST distribution program includes extended payment terms to Bristol Myers Squibb authorized POMALYST distributors. Healthcare providers and institutions should contact their POMALYST distributor to understand specific payment terms that may be available to them from their distributor.
Please see U.S. Full Prescribing Information for POMALYST, including Boxed WARNINGS.
FDA Approval Letters as Posted by the FDA:
In combination with dexamethasone, for treatment of patients with multiple myeloma who have received at least two prior therapies including lenalidomide and a proteasome inhibitor and have demonstrated disease progression on or within 60 days of completion of the last therapy
View Letter
For the treatment of adult patients with AIDS-related Kaposi sarcoma (KS) after failure of highly active antiretroviral therapy (HAART) or in patients with KS who are HIV-negative†
View Letter
†This indication is approved under accelerated approval based on overall response rate. Continued approval for this indication may be contingent upon verification and description of clinical benefit in a confirmatory trial(s).
Please see U.S. Full Prescribing Information for POMALYST, including Boxed WARNINGS.
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.