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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.
- Codes*
- Distribution
- FDA Letters
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50 mg/individual blister packs of 1 capsule
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50 mg/individual blister packs of 28 capsules
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100 mg/individual blister packs of 28 capsules
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150 mg/individual blister packs of 28 capsules
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200 mg/individual blister packs of 28 capsules
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Multiple myeloma and malignant plasma cell neoplasms
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Multiple myeloma
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Leprosy (Hansen’s disease)
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Indeterminate leprosy
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Tuberculoid leprosy
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Borderline tuberculoid leprosy
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Borderline leprosy
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Borderline lepromatous leprosy
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Lepromatous leprosy
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Other forms of leprosy
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Leprosy, unspecified
Coding for THALOMID 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 THALOMID, including Boxed WARNINGS.
Prescribers and pharmacies must be certified with the THALOMID REMS® program by enrolling and complying with the REMS requirements; pharmacies must only dispense to patients who are authorized to received THALOMID. The REMS-Pharmacy Network list includes specialty pharmacies that are contracted to fill prescriptions for restricted distribution programs for Bristol Myers Squibb.
| 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 06/22.
The THALOMID distribution program includes extended payment terms to Bristol Myers Squibb authorized THALOMID distributors. Healthcare providers and institutions should contact their THALOMID distributor to understand specific payment terms that may be available to them from their distributor.
Please see U.S. Full Prescribing Information for THALOMID, including Boxed WARNINGS.
FDA Approval Letters as Posted by the FDA:
For the treatment of patients with newly diagnosed multiple myeloma in combination with dexamethasone
View Letter
For the acute treatment of cutaneous manifestations of moderate to severe ENL (erythema nodosum leprosum)
View Letter
Note: THALOMID is not indicated as monotherapy for such ENL treatment in the presence of moderate to severe neuritis.
For maintenance therapy for the prevention and suppression of the cutaneous manifestations of ENL recurrence
View Letter
Please see U.S. Full Prescribing Information for THALOMID, 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.
2015-US-2100007 06/21
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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 06/22.
2015-US-2100009 06/22