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ASCENIV™ ORDERING
& BILLING INFORMATION

ASCENIV™ ORDERING 
& BILLING INFORMATION

Ordering

How to order ASCENIV

To place an order for ASCENIV (immune globulin intravenous, human – slra) please see information below:

ADMA Biologics
Customer Operations
5800 Park of Commerce Blvd, NW
Boca Raton, FL 33487

Toll free: 800-458-4244, option 1

Email: CustomerService@admabio.com

billing & coding

Billing codes—IV administration of ASCENIV

The information contained in this guide is provided for informational purposes only and is current as of May 2023. 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

J1554 Injection, immune globulin (ASCENIV), 500 mg
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 call 1-800-458-4244.

aCenters for Medicare and Medicaid Services (CMS). HCPCS file located at:
https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/HCPCS-Quarterly-Update;
https://www.cms.gov/files/zip/july-2023-alpha-numeric-hcpcs-file.zip.

bReporting 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.

cNational Uniform Billing Committee (NUBC) guidance located at: https://www.nubc.org/.

dOptum® 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.

Indication

ASCENIV (immune globulin intravenous, human – slra) is a 10% immune globulin liquid for intravenous injection, indicated for the treatment of primary humoral immunodeficiency (PI) in adults and adolescents (12 to 17 years of age). PI includes, but is not limited to, the humoral immune defect in congenital agammaglobulinemia, common variable immunodeficiency (CVID), X linked agammaglobulinemia, Wiskott-Aldrich syndrome, and severe combined immunodeficiencies (SCID).

 

Important Safety Information for ASCENIV™

WARNING: THROMBOSIS, RENAL DYSFUNCTION AND ACUTE RENAL FAILURE

  • Thrombosis may occur with immune globulin (IGIV) products, including ASCENIV. Risk factors may include: advanced age, prolonged immobilization, hypercoagulable conditions, history of venous or arterial thrombosis, use of estrogens, indwelling central vascular catheters, hyperviscosity, and cardiovascular risk factors. Thrombosis may occur in the absence of known risk factors.
  • Renal dysfunction, acute renal failure, osmotic nephrosis, and death may occur with the administration of IVIG products in predisposed patients.
  • Renal dysfunction and acute renal failure occur more commonly in patients receiving IGIV products containing sucrose. ASCENIV does not contain sucrose.
  • For patients at risk of thrombosis, renal dysfunction or renal failure, administer ASCENIV at the minimum dose and infusion rate practicable. Ensure adequate hydration in patients before administration. Monitor for signs and symptoms of thrombosis and assess blood viscosity in patients at risk for hyperviscosity.