Codes and coverage

Codes and coverage

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
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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.

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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
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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.

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Reimbursement and Coding Guide
for ONUREG

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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.

59572-0730-07 Copy 200-mg tablets; one blister card containing 7 tablets
59572-0740-07 Copy 300-mg tablets; one blister card containing 7 tablets

International Classification of Diseases, Tenth Revision, Clinical Modification Diagnosis Codes (ICD-10-CM)2

C92 Copy Myeloid leukemia
C92.0 Copy Acute myeloblastic leukemia
C92.00 Copy Acute myeloblastic leukemia, not having achieved remission
C92.01 Copy Acute myeloblastic leukemia, in remission
C92.5 Copy Acute myelomonocytic leukemia
C92.50 Copy Acute myelomonocytic leukemia, not having achieved remission
C92.51 Copy Acute myelomonocytic leukemia, in remission
C92.6 Copy Acute myeloid leukemia with 11q23-abnormality
C92.60 Copy Acute myeloid leukemia with 11q23-abnormality, not having achieved remission
C92.61 Copy Acute myeloid leukemia with 11q23-abnormality, in remission
C92.A Copy Acute myeloid leukemia with multilineage dysplasia
C92.A0 Copy Acute myeloid leukemia with multilineage dysplasia, not having achieved remission
C92.A1 Copy Acute myeloid leukemia with multilineage dysplasia, in remission
C92.Z Copy Other myeloid leukemia
C92.Z0 Copy Other myeloid leukemia, not having achieved remission
C92.Z1 Copy Other myeloid leukemia, in remission
C92.9 Copy Myeloid leukemia, unspecified
C92.90 Copy Myeloid leukemia, unspecified, not having achieved remission
C92.91 Copy Myeloid leukemia, unspecified, in remission
C93 Copy Monocytic leukemia
C93.0 Copy Acute monoblastic/monocytic leukemia
C93.00 Copy Acute monoblastic/monocytic leukemia, not having achieved remission
C93.01 Copy Acute monoblastic/monocytic leukemia, in remission
C94 Copy Other leukemias of specified cell type
C94.0 Copy Acute erythroid leukemia
C94.00 Copy Acute erythroid leukemia, not having achieved remission
C94.01 Copy Acute erythroid leukemia, in remission
C94.2 Copy Acute megakaryoblastic leukemia
C94.20 Copy Acute megakaryoblastic leukemia, not having achieved remission
C94.21 Copy Acute megakaryoblastic leukemia, in remission

*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.

This is a category code and is invalid for stand-alone use. Please use the expanded code listed below.

Please see U.S. Full Prescribing Information for ONUREG.

References:

  1. ONUREG (azacitidine) tablets [package insert]. Princeton, NJ: Bristol-Myers Squibb Company.
  2. Centers for Medicare & Medicaid Services. ICD-10-CM tabular list of diseases and injuries. https://www.cms.gov/medicare/coding-billing/icd-10-codes/2023-icd-10-cm. Accessed August 2, 2023.

The following distributors are authorized to sell ONUREG and are able to service qualified accounts.

Physician Offices

Specialty Distributor Phone Orders Fax Orders and Website
Cardinal Health Specialty Pharmaceutical Distribution 1‑877‑453‑3972 https://specialtyonline.cardinalhealth.com
CuraScript Specialty Distribution 1‑877‑599‑7748 https://www.curascriptsd.com
McKesson Specialty Health 1‑800‑482‑6700 https://mscs.mckesson.com
Morris & Dickson Specialty 1‑800‑710‑6100 Fax: 1‑318‑524‑3096
https://www.mdspecialtydist.com
Oncology Supply 1‑800‑633‑7555 https://www.oncologysupply.com

Hospitals and Infusion Centers

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: 1‑614‑553‑6301
https://orderexpress.cardinalhealth.com
McKesson Plasma and Biologics 1‑877‑625‑2566 Fax: 1‑888‑752‑7626
https://connect.mckesson.com
Morris & Dickson Specialty 1‑800‑710‑6100 Fax: 1‑318‑524‑3096
https://www.mdspecialtydist.com

Puerto Rico Hospitals and Clinics

Authorized Distributor Phone Orders Fax Orders and Website
Amerisource
Bergen Puerto Rico
1‑844‑222‑2273 https://abcorder.amerisourcebergen.com
Cardinal Puerto Rico (Borschow) 1‑787‑625‑4200 https://www.cardinalhealth.pr
Cesar Castillo, Inc. 1‑787‑641‑5242 (Hospitals)
1‑787‑641‑5082 (Specialty Pharmacies)
Fax: 1‑787‑999‑1614 https://www.facilfarmaciacci.com

Above information is accurate as of 12/23.

ONUREG is available through external specialty pharmacies. Please check with your patient's insurance plan for the appropriate specialty pharmacy.

ONUREG 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).

Please see U.S. Full Prescribing Information for ONUREG.

FDA Approval Letter as Posted by the FDA:

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ONUREG for the continued treatment of adult patients with acute myeloid leukemia who achieved first complete remission (CR) or complete remission with incomplete blood count recovery (CRi) following intensive induction chemotherapy and are not able to complete intensive curative therapy – Approved on 09/01/2020

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Please see U.S. Full Prescribing Information for ONUREG.