TROGARZO Billing Coding Guide
User Manual:
Open the PDF directly: View PDF .
Page Count: 1
Download | ![]() |
Open PDF In Browser | View PDF |
Billing and Coding Guide PATIENT COVERAGE 1) Complete a TROGARZO™ Enrollment Form and FAX the patient’s enrollment package to THERA patient support™ at 1-855-836-3069. 2) A Patient Care Coordinator will then assess and advise on the patient’s private or government insurance coverage. The Patient Care Coordinator will also assist in applying any eligible co-pay assistance. 3) TROGARZO™ may then be ordered and infused at your office. HOW TO ORDER TROGARZO™ Authorized Distributor: Curascript SD Telephone 1-877-599-7748 (Mon-Fri 8:30AM-7PM ET) Fax 1-800-862-6208 Website www.curascriptsd.com For information on payment, shipping or return policies, please contact Curascript SD directly. PRODUCT INFORMATION NDC Description 62064-122-02 Pack of 2 vials, each containing 200 mg of ibalizumab-uiyk for intravenous infusion ICD-10 Code Description B20 Human immunodeficiency virus [HIV] disease CPT Code Description 96365 IV infusion for therapy, prophylaxis, or diagnosis; initial, up to 1 hour HCPCS Code Description J3490 Unclassified drug J3590 Unclassified biologic Please check with payer to verify coding or special billing requirements. Correct coding is the responsibility of the provider submitting a claim for the item or service. Questions? Contact us at 1-833-23-THERA (1-833-238-4372), Mon-Fri 8AM-8PM ET TROGARZOTM is a trademark of TaiMed Biologics Inc., under license to Theratechnologies Inc. © 2018 Theratechnologies Inc. All rights reserved. 348-01-11/17
Source Exif Data:
File Type : PDF File Type Extension : pdf MIME Type : application/pdf PDF Version : 1.5 Linearized : Yes Create Date : 2018:03:12 11:26:04-04:00 Creator : Adobe InDesign CC 13.0 (Macintosh) Modify Date : 2018:03:12 11:36:54-04:00 Language : en-US XMP Toolkit : Adobe XMP Core 5.2-c001 63.139439, 2010/09/27-13:37:26 Metadata Date : 2018:03:12 11:36:54-04:00 Creator Tool : Adobe InDesign CC 13.0 (Macintosh) Instance ID : uuid:6d2fb28f-9c77-4733-b0aa-3a7d4e348ab0 Original Document ID : xmp.did:fa558d9f-e77c-48f8-83be-1c131a451eb1 Document ID : xmp.id:7acdcf07-d5ef-4d5f-8f70-dadc3d48cd2c Rendition Class : proof:pdf Derived From Instance ID : xmp.iid:c5de5635-b961-4279-89fa-b55136ea6dbc Derived From Document ID : xmp.did:9b7f21b5-ba42-4ed2-9b58-4f3d1a8d9da0 Derived From Original Document ID: xmp.did:fa558d9f-e77c-48f8-83be-1c131a451eb1 Derived From Rendition Class : default History Action : converted History Parameters : from application/x-indesign to application/pdf History Software Agent : Adobe InDesign CC 13.0 (Macintosh) History Changed : / History When : 2018:03:12 11:26:04-04:00 Format : application/pdf Producer : Adobe PDF Library 15.0 Trapped : False Slug Family : Gotham Slug Version : 3.201 Slug Outline File Size : 0 Slug Kerning Checksum : 0 Slug Foundry : -- Slug Font Kind : OpenType - PS Slug Checksum : 1333265771 Slug Post Script Name : Gotham-Book Slug Font Sense 12 Checksum : 1333265771 Page Count : 1EXIF Metadata provided by EXIF.tools