Billing and Coding Information

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LARTRUVO Billing and Coding Information

Use this information when preparing documentation for LARTRUVO use.

HCPCS Codes

Code

Description

Setting

J9285

Injection, olaratumab, 10 mg

For physician office use

NDC*

Code

Dosage form and strength

00002-8926-01*

LARTRUVO (olaratumab for injection) 500 mg/50 mL (10 mg/mL) solution, single-dose vial

00002-7190-01*

LARTRUVO (olaratumab for injection) 190 mg/19 mL (10 mg/mL) solution, single-dose vial

Diagnosis Codes

Only the Non-GIST soft tissue sarcoma codes

All coding and documentation requirements for drugs should be confirmed with each payer. This is not a comprehensive list. Additional codes may be used for soft tissue sarcomas. Please refer to the plan for a determination of benefits.

ICD-10-CM Code

Description

C49

Malignant neoplasm of other connective and soft tissue

C49.1

Malignant neoplasm of connective and soft tissue of upper limb, including shoulder

C49.10

Malignant neoplasm of connective and soft tissue of unspecified upper limb, including shoulder

C49.11

Malignant neoplasm of connective and soft tissue of right upper limb, including shoulder

C49.12

Malignant neoplasm of connective and soft tissue of left upper limb, including shoulder

C49.2

Malignant neoplasm of connective and soft tissue of lower limb, including hip

C49.20

Malignant neoplasm of connective and soft tissue of unspecified lower limb, including hip

C49.21

Malignant neoplasm of connective and soft tissue of right lower limb, including hip

C49.22

Malignant neoplasm of connective and soft tissue of left lower limb, including hip

C49.3

Malignant neoplasm of connective and soft tissue of thorax

C49.4

Malignant neoplasm of connective and soft tissue of abdomen

C49.5

Malignant neoplasm of connective and soft tissue of pelvis

C49.6

Malignant neoplasm of connective and soft tissue of trunk, unspecified

C49.8

Malignant neoplasm of overlapping sites of connective and soft tissue

C49.9

Malignant neoplasm of connective and soft tissue, unspecified

C47.0

Malignant neoplasm of peripheral nerves of head, face, and neck

C47.1 

 

Malignant neoplasm of peripheral nerves of upper limb, including shoulder

C47.10

Malignant neoplasm of peripheral nerves of unspecified upper limb, including shoulder

C47.11

Malignant neoplasm of peripheral nerves of right upper limb, including shoulder

C47.12

Malignant neoplasm of peripheral nerves of left upper limb, including shoulder

C47.2

Malignant neoplasm of peripheral nerves of lower limb, including hip

C47.20

Malignant neoplasm of peripheral nerves of unspecified lower limb, including hip

C47.21

Malignant neoplasm of peripheral nerves of right lower limb, including hip

C47.22

Malignant neoplasm of peripheral nerves of left lower limb, including hip

C47.3

Malignant neoplasm of peripheral nerves of thorax

C47.4

Malignant neoplasm of peripheral nerves of abdomen

C47.5

Malignant neoplasm of peripheral nerves of pelvis

C47.6

Malignant neoplasm of peripheral nerves of trunk, unspecified

C47.8

Malignant neoplasm of overlapping sites of peripheral nerves and autonomic nervous system

C47.9

Malignant neoplasm of peripheral nerves and autonomic nervous system, unspecified

C48.0

Malignant neoplasm of retroperitoneum and peritoneum

C48.1

Malignant neoplasm of specified parts of peritoneum

C48.2

Malignant neoplasm of peritoneum, unspecified

C48.8

Malignant neoplasm of overlapping sites of retroperitoneum and peritoneum

C53.0

Malignant neoplasm of endocervix

C54.0

Malignant neoplasm of isthmus uteri

C54.1

Malignant neoplasm of endometrium

C54.2

Malignant neoplasm of myometrium

C54.3

Malignant neoplasm of fundus uteri

C54.8

Malignant neoplasm of overlapping sites of corpus uteri

C54.9

Malignant neoplasm of corpus uteri, unspecified

C55

Malignant neoplasm of uterus, part unspecified

C78.00

Secondary malignant neoplasm of unspecified lung

C78.01

Secondary malignant neoplasm of right lung

C78.02

Secondary malignant neoplasm of left lung

Z80.49

Family history of malignant neoplasm of other genital organs

Z85.831

Personal history of malignant neoplasm of soft tissue

Drug Administration CPT® Code

Code

Description

96413

Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug

*FDA standard NDC has been "zero-filled" to ensure creation of an 11-digit code that meets HIPAA standards. The zero-fill location is indicated in bold.


Ordering Information

Lilly has contracted with a network of specialty distributors and one specialty pharmacy to provide customers access to LARTRUVO.

If purchasing LARTRUVO directly, you may use one of the five specialty distributors listed here. You also have the option of ordering from our authorized specialty pharmacy partner shown below. For more information on purchasing, dispensing, or returning Lilly products, visit LillyTrade.com. For inquiries about this matter, contact Lilly at 1-800-LillyRx (1-800-545-5979).

Specialty Distributor Network

AmerisourceBergen Specialty Group

Order Entry Code: 190 mg/19 mL and 500 mg/50 mL (10 mg/ml) - 47664
Oncology SupplyASD Healthcare
P: (800) 633-7555, F: (800) 248-8205
oncologysupply.com
P: (800) 746-6273, F: (800) 547-9413
classasdhealthcare.com

Cardinal Health Specialty Pharmaceutical Distribution

Order Entry Code: 190 mg/19 mL and 500 mg/50 mL (10 mg/mL) - 5261003
Oncology ClinicsHospitals
P: (877) 453-3972, F: (888) 345-4916
cardinalhealth.com/specialtyonline
P: (866) 677-4844, F: (888) 345-4916
cardinalhealth.com/specialtyonline

CuraScript Specialty Distribution

Order Entry Code: 500 mg/50 mL (10 mg/10 mL) - 268348
P: (877) 599-7748, F: (800) 862-6208, curascriptsd.com

McKesson Specialty Care Distribution Corporation

Order Entry Code: 500 mg/50 mL (10 mg/ml) - 5005803
McKesson Specialty HealthMcKesson Plasma and Biologics
P: (800) 482-6700, F: (800) 289-9285
mscs.mckesson.com
P: (877) 625-2566, F: (888) 752-7626
connect.mckesson.com

Smith Medical Partners

Order Entry Code: 190 mg/19 mL and 500 mg/50 mL (10 mg/ml) - 5620109
P: (800) 292-9653, F: (630) 227-9220, smpspecialty.com

Authorized Specialty Pharmacy

Accredo

P: (877) 732-3431, F: (800) 391-0707, accredo.com

This information is presented for informational purposes only and is not intended to provide reimbursement or legal advice. Laws, regulations, and policies concerning reimbursement are complex and are updated frequently. Individual coding decisions should be based upon diagnosis and treatment of individual patients. Eli Lilly and Company does not guarantee success in obtaining insurance payments. While we have made an effort to be current as of the issue date of this website, the information may not be as current or comprehensive when you view it. Providers should contact third-party payers for specific information on their coverage, coding, and payment policies. Please consult with your legal counsel or reimbursement specialist for any reimbursement or billing questions. For more information, please call the Lilly PatientOne program at 1-866-472-8663.