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 SPRYCEL
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Codes*

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Type a keyword to find a specific NDC or ICD-10 code

National Drug Codes (NDC)¹Issued by the FDA

0003-0527-11

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20 mg tablet, 60 tablets per bottle

0003-0528-11

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50 mg tablet, 60 tablets per bottle

0003-0524-11

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70 mg tablet, 60 tablets per bottle

0003-0855-22

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80 mg tablet, 30 tablets per bottle

0003-0852-22

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100 mg tablet, 30 tablets per bottle

0003-0857-22

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140 mg tablet, 30 tablets per bottle

International Classification of Diseases, Tenth Revision, Clinical Modification Diagnosis Codes (ICD-10-CM)²

Adult and Pediatric Chronic Myeloid Leukemia

C92

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Myeloid leukemia

C92.1

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Chronic myeloid leukemia (CML), BCR/ABL-positive^†

C92.10

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Chronic myeloid leukemia, BCR/ABL-positive, not having achieved remission

C92.11

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Chronic myeloid leukemia, BCR/ABL-positive, in remission

C92.12

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Chronic myeloid leukemia, BCR/ABL-positive, in relapse

Adult Acute Lymphoblastic Leukemia

C91

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Lymphoid leukemia

C91.0

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Acute lymphoblastic leukemia (ALL)^†

C91.00

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Acute lymphoblastic leukemia, not having achieved remission

C91.01

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Acute lymphoblastic leukemia, in remission

C91.02

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Acute lymphoblastic leukemia, in relapse

Pediatric Acute Lymphoblastic Leukemia

C91

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Lymphoid leukemia

C91.0

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Acute lymphoblastic leukemia (ALL)^†

C91.00

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Acute lymphoblastic leukemia, not having achieved remission

C91.01

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Acute lymphoblastic leukemia, in remission

*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.

^†This is a category code and is invalid for stand-alone use.

References:

SPRYCEL [package insert]. Princeton, NJ: Bristol-Myers Squibb Company.
Centers for Medicare & Medicaid Services. ICD-10-CM tabular list of diseases and injuries. https://www.cms.gov/Medicare/Coding/ICD10/2020-ICD-10-CM. Accessed February 7, 2022.

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