Billing codes—IV administration of ASCENIV™

The information contained in this guide is provided for informational purposes only and is current as of September 2019. Every reasonable effort has been made to verify the accuracy of the information; however, providers are encouraged to contact their payers for specific information as coding rules and guidelines are subject to payer discretion and should be verified by the paying entity. It is the provider’s sole responsibility to determine and submit appropriate codes, charges, and modifiers for services rendered. The information provided in this guide is subject to change without notice.

Healthcare providers make the ultimate determination as to when to use a specific product based on clinical appropriateness for a patient. Third-party payment for medical products and services is affected by numerous factors, and ADMA Biologics cannot guarantee success in obtaining insurance payments.

HCPCS Codesa

HCPCS Code Description
J3590 Unclassified biologics
J3490 Unclassified drugs
J1599 Injection, immune globulin, intravenous, non-lyophilized (e.g, liquid), not otherwise specified, 500 mg

NDC Numbersb

Outer Package
NDC Number*
Size Grams Protein Inner Package
NDC Number
69800-0250-01 50 mL 5 69800-0250-2

*Use the Outer Package 11-digit NDC number for billing purposes.

Hospital Revenue Codec

Code Description
0636 Pharmacy, drugs requiring detailed coding

CPT® Codesd—IV Infusion

CPT Code Description
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (list separately in addition to code for primary procedure)
For additional information please visit www.asceniv.com or call 1-800-458-4244.
DOWNLOAD CODING INFORMATION (PDF)
a
Centers for Medicare and Medicaid Services (CMS). HCPCS file located at:
http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/Alpha-Numeric-HCPCS.html.
b
Reporting drugs with unclassified codes typically requires additional product-identifying information that may include one or more of the following: brand and generic name of drug, drug strength and dose administered, 11-digit National Drug Code (NDC), and route of administration.
c
National Uniform Billing Committee (NUBC) guidance located at: http://www.nubc.org/.
d
Optum® Current Procedural Coding Expert, publisher of CPT, a registered trademark of the AMA. Copyright 2017 American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association.