OCREVUS sample coding

Treatment with OCREVUS is eligible for reimbursement under most major commercial insurance plans as well as medicare and medicaid programs. The following table includes sample coding information when filing claims for reimbursement for OCREVUS.

Diagnosis: ICD-10-CM

CODE DESCRIPTION
G35 Multiple sclerosis

Drug: HCPCS

CODE DESCRIPTION
J2350
Injection, ocrelizumab, 1 mg

Home Infusion: HCPCS

CODE DESCRIPTION
S9329
Home infusion therapy, chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code with S9330 or S9331)
S9379 Home infusion therapy, infusion therapy, not otherwise classified; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem

Drug: NDC

CODE DESCRIPTION

10‑Digit

50242-150-01

ocrelizumab, 300 mg vial
11‑Digit

50242-0150-01

Administration procedures: CPT*

CODE DESCRIPTION
96413 Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug
96415 Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure)
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)
99601 Home infusion/specialty drug administration, per visit (up to 2 hours)

99602

Home infusion/specialty drug administration, per visit (up to 2 hours); each additional hour (List separately in addition to code for primary procedure)    

For informational purposes only and is subject to change. Please consult with the payer to verify codes and understand the payer’s specific billing requirements.

*For payers who do not yet recognize OCREVUS as approved for chemotherapy administration codes 96413 and 96415, other administration codes, such as 96365 and 96366, may be used depending on individual payer policy.

CPT=Current Procedural Terminology; HCPCS=Healthcare Common Procedure Coding System; ICD-10-CM=International Classification of Diseases, 10th Revision, Clinical Modification; NDC=National Drug Code.

Find more Information

For more information on OCREVUS coding and reimbursement or to find forms to get started, please visit Access Solutions.