This information is intended for U.S. healthcare professionals and/or
healthcare professionals involved in healthcare reimbursement.
This site is intended for U.S. residents 18 years of age or older.
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Supporting patient access
BMS Access Support® may help support patient access by conducting benefits reviews and offering prior authorization and appeals process assistance for enrolled patients. Additionally, the information below provides product-specific billing and diagnosis codes, reimbursement and coding guides, distribution information, and additional coverage support offerings. To view available coding and coverage information, please select your patient’s prescribed medication.
Additional eligibility criteria and terms may apply. Bristol Myers Squibb and its agents make no guarantee regarding reimbursement for any service or item.
Read more about our coverage support offerings
Benefits Reviews
- Once a patient is enrolled in BMS Access Support, we can review their insurance coverage and provide a summary of benefits within approximately 24 hours*
- A benefits review may help determine whether or not a medication is covered, if a PA is required, and estimated patient out-of-pocket costs
*BMS Access Support Data - Benefits review. Accessed August 2022.
Prior Authorization (PA) and Appeals Assistance
- Use the BMS Access Map to identify plan-specific PA requirements
- View our forms and resources page for helpful support tools, including appeals letter templates and medical necessity letters
Annual Reverification
- Reverification of benefits is available upon request to confirm a patient’s benefits for the new year
- Connect with your local Access and Reimbursement Manager for more information
The accurate completion of reimbursement- or coverage-related documentation is the responsibility of the healthcare provider and patient. Bristol Myers Squibb and its agents make no guarantee regarding reimbursement for any service or item.
Reimbursement and Coding Guide
for KRAZATI
Additional coverage support offerings
Free Trial Offer
A free trial offer may be available for patients newly prescribed KRAZATI.
Bridge Program
Has your commercially insured patient experienced a delay in coverage or a coverage denial for KRAZATI? They may be eligible for a bridge program while they await coverage.
To learn more about the eligibility requirements for the Free Trial offer or Bridge Program, call BMS Access Support at 1-800-861-0048 or reach out to your local Access and Reimbursement Manager for more information.
Restrictions apply. Please see full Terms and Conditions, including complete eligibility requirements.
Filter results by:
National Drug Codes (NDC)1
Issued by the FDA
Note: Payers require the submission of the 11-digit NDC on healthcare claim forms. Please use the 11-digit codes shown here.
| 80739-0812-18 Copy | 200 mg tablets, bottle of 180 tablets |
International Classification of Diseases, Tenth Revision, Clinical Modification Diagnosis Codes (ICD-10-CM)2
Colorectal Cancer ICD-10 Codes
| C18 Copy | Malignant neoplasm of colon |
| C18.0 Copy | Malignant neoplasm of cecum |
| C18.1 Copy | Malignant neoplasm of appendix |
| C18.2 Copy | Malignant neoplasm of ascending colon |
| C18.3 Copy | Malignant neoplasm of hepatic flexure |
| C18.4 Copy | Malignant neoplasm of transverse colon |
| C18.5 Copy | Malignant neoplasm of splenic flexure |
| C18.6 Copy | Malignant neoplasm of descending colon |
| C18.7 Copy | Malignant neoplasm of sigmoid colon |
| C18.8 Copy | Malignant neoplasm of overlapping sites of colon |
| C18.9 Copy | Malignant neoplasm of colon, unspecified |
| C19 Copy | Malignant neoplasm of rectosigmoid junction |
| C20 Copy | Malignant neoplasm of rectum |
| C21.8 Copy | Malignant neoplasm of overlapping sites of rectum, anus and anal canal |
| D37.4 Copy | Neoplasm of uncertain behavior of colon |
| D37.5 Copy | Neoplasm of uncertain behavior of rectum |
Non-Small Cell Lung Cancer Codes ICD-10 Codes
| C34 Copy | Malignant neoplasm of bronchus and lung |
| C34.0 Copy | Malignant neoplasm of main bronchus |
| C34.00 Copy | Malignant neoplasm of unspecified main bronchus |
| C34.01 Copy | Malignant neoplasm of right main bronchus |
| C34.02 Copy | Malignant neoplasm of left main bronchus |
| C34.1 Copy | Malignant neoplasm of upper lobe, bronchus or lung |
| C34.10 Copy | Malignant neoplasm of upper lobe, unspecified bronchus or lung |
| C34.11 Copy | Malignant neoplasm of upper lobe, right bronchus or lung |
| C34.12 Copy | Malignant neoplasm of upper lobe, left bronchus or lung |
| C34.2 Copy | Malignant neoplasm of middle lobe, bronchus or lung |
| C34.3 Copy | Malignant neoplasm of lower lobe, bronchus or lung |
| C34.30 Copy | Malignant neoplasm of lower lobe, unspecified bronchus or lung |
| C34.31 Copy | Malignant neoplasm of lower lobe, right bronchus or lung |
| C34.32 Copy | Malignant neoplasm of lower lobe, left bronchus or lung |
| C34.8 Copy | Malignant neoplasm of overlapping sites of bronchus and lung |
| C34.80 Copy | Malignant neoplasm of overlapping sites of unspecified bronchus and lung |
| C34.81 Copy | Malignant neoplasm of overlapping sites of right bronchus and lung |
| C34.82 Copy | Malignant neoplasm of overlapping sites of left bronchus and lung |
| C34.9 Copy | Malignant neoplasm of unspecified part of bronchus or lung |
| C34.90 Copy | Malignant neoplasm of unspecified part of unspecified bronchus or lung Lung cancer NOS |
| C34.91 Copy | Malignant neoplasm of unspecified part of right bronchus or lung |
| C34.92 Copy | Malignant neoplasm of unspecified part of left bronchus or lung |
| C38.4 Copy | Malignant neoplasm of pleura |
| C39.9 Copy | Malignant neoplasm of lower respiratory tract, part unspecified |
| C7A.09 Copy | Malignant carcinoid tumors of other sites |
| C7A.090 Copy | Malignant carcinoid tumor of the bronchus and lung |
Coding for KRAZATI is dependent on the insurer and the care setting in which the drug will be administered. Oncology practices need to make coding decisions based on the diagnosis and treatment of each patient and the specific insurer requirements.
Please see U.S. Full Prescribing Information for KRAZATI.
NOS=not otherwise specified.
*Healthcare providers should code healthcare claims based upon the service that is rendered, the patient’s medical record, the coding requirements of each health insurer, and best coding practices. Coding guidance provided under this heading does not provide a guarantee of reimbursement and should be considered together with all applicable coding guidance and standards. All of the coding information presented by this website is applicable to outpatient procedures only.
References:
- KRAZATI [package insert]. Princeton, NJ: Bristol-Myers Squibb Company.
- Centers for Medicare & Medicaid Services. ICD-10-CM tabular list of diseases and injuries. https://www.cms.gov/medicare/coding-billing/icd-10-codes/2024-icd-10-cm. Accessed September 30, 2024.
Contact one of these authorized in-network specialty pharmacies or distributors for access to KRAZATI.
Specialty Pharmacies
| Specialty Pharmacies | Phone Orders | Fax Orders and Website |
|---|---|---|
| Biologics by McKesson | 1‑800‑850‑4306 | Fax: 1‑800‑823‑4506 https://biologics.mckesson.com |
| Onco360 Oncology Pharmacy | 1‑877‑662‑6633 | Fax: 1‑877‑662‑6355 https://www.onco360.com |
Physician Offices
| Specialty Distributor | Phone Orders | Fax Orders and Website |
|---|---|---|
| Cardinal Health Specialty Pharmaceutical Distribution | 1‑866‑677‑4844 | https://specialtyonline.cardinalhealth.com |
| McKesson Specialty Health | 1‑800‑482‑6700 | https://mscs.mckesson.com |
| Oncology Supply | 1‑800‑633‑7555 | https://www.oncologysupply.com |
Hospitals/Institutions
| Specialty Distributor | Phone Orders | Fax Orders and Website |
|---|---|---|
| ASD Healthcare | 1-800‑746‑6273 | Fax: 1‑800‑547‑9413 https://www.asdhealthcare.com |
| Cardinal Health Specialty Pharmaceutical Distribution | 1‑866‑677‑4844 | Fax: 1‑614‑553‑5919 https://orderexpress.cardinalhealth.com |
| McKesson Plasma and Biologics | 1‑877‑625‑2566 | Fax: 1‑888‑752‑7626 https://connect.mckesson.com |
Above information is accurate as of 10/24.
KRAZATI is available through external specialty pharmacies. Please check with your patient’s insurance plan for the appropriate specialty pharmacy.
KRAZATI can also be procured by the practice directly from one of the authorized distributors in the list above. Please ensure your practice has the durable medical equipment (DME) license in place to bill the appropriate DME Medicare Administrative Contractor (DME MAC).
The KRAZATI distribution program includes extended payment terms to Bristol Myers Squibb authorized KRAZATI distributors. Healthcare providers and institutions should contact their KRAZATI distributor to understand specific payment terms that may be available to them from their distributor.
Please see U.S. Full Prescribing Information for KRAZATI.
FDA Approval Letters as Posted by the FDA:
KRAZATI is indicated for the treatment of adult patients with KRAS G12C-mutated locally advanced or metastatic non-small cell lung cancer (NSCLC), as determined by an FDA-approved test, who have received at least one prior systemic therapy – Approved on 12/12/2022
View Letter
KRAZATI in combination with cetuximab is indicated for the treatment of adult patients with KRAS G12C-mutated locally advanced or metastatic colorectal cancer, as determined by an FDA approved test, who have been previously treated with fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy – Approved on 06/21/2024
View LetterPlease see U.S. Full Prescribing Information for KRAZATI.
