TEZSPIRE BILLING AND CODING GUIDE

National Drug Code (NDC)1 Administration MethodDosageCodePhysician Administered: Prefilled SyringeCarton contains one 210 mL (110 mg/mL) prefilled syringe10-digit NDC55513-112-0111-digit NDC55513-0112-01 Although the FDA uses a 10-digit format when registering NDC numbers, payers often require an 11-digit NDC format on claim forms for BILLING purposes. It is important to confirm with your payer which NDC format is required. In addition, Medicaid requires that all claims for provider-administered drugs include NDC reporting requirement may also be implemented by some commercial payers. Guidelines for reporting the NDC number in the appropriate format, quantity, and unit of measure vary by state and by payer and should be reviewed prior to submitting a Common Procedure CODING System (HCPCS)2 CodeDescriptionJ2356 Injection, tezepelumab-ekko, 1 mg For dates of service on or after July 1, 2022, healthcare providers administering TEZSPIRE can begin using the new Healthcare Common Procedure CODING System (HCPCS) code assigned by the Centers for Medicare & Medicaid Services (CMS) and discontinue use of the temporary codes J3590, J3490, and C9399 Current Procedural Terminology (CPT) 3 DescriptionInjection AdministrationHealthcare providers should consult the payer or Medicare contractor to determine the code most a

Please see additional Important Safety Information on page 4. TEZSPIRE BILLING AND CODING GUIDE 1. PLEASE PRINT OR TYPE APPROVED OMB-0938-1197 FORM 1500 (02-12) ... This sample form is intended as a reference for coding and billing for product and associated services. It is not intended to be directive,

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