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11/12/2018
AstraZeneca is pleased to announce that IMFINZI® (durvalumab) injection has been assigned a unique HCPCS code by the Centers for Medicare & Medicaid Services (CMS).
Effective for dates of services on or after January 1, 2019, the following code can be used to identify IMFINZI® (durvalumab) when billing across settings of care as noted in the Medicare Program: Changes to Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs available at:
https://s3.amazonaws.com/public-inspection.federalregister.gov/2018-24243.pdf
Code |
Description |
Vial Size |
Billing Units |
NDC |
J9173 |
Injection, durvalumab, 10 mg1 |
500 mg/10 mL |
50 units |
0310-4611-50 |
120 mg/2.4 mL |
12 units |
0310-4500-12 |
Each provider is responsible for ensuring all coding is accurate and documented in the medical record based on the condition of the patient. The use of this information does not guarantee reimbursement. Healthcare providers are encouraged to contact payers to confirm code adoption and approved usage prior to submitting claims.
AstraZeneca Access 360™ can help with questions you may have about coding and reimbursement. For additional assistance, please contact your Reimbursement Counselor at 1-833-360-4357, Monday through Friday from 8 AM to 8 PM Eastern Time, or visit www.MyAccess360.com.
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