TROGARZO Billing Coding Guide

User Manual:

Open the PDF directly: View PDF PDF.
Page Count: 1

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 oce.
HOW TO ORDER
TROGARZO™ Authorized Distributor: Curascript SD
For information on payment, shipping or return policies, please contact Curascript SD directly.
Telephone 1-877-599-7748 (Mon-Fri 8:30AM-7PM ET)
Fax 1-800-862-6208
Website www.curascriptsd.com
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.
PRODUCT INFORMATION
NDC Description
62064-122-02 Pack of 2 vials, each containing 200 mg of ibalizumab-uiyk
for intravenous infusion
HCPCS Code Description
J3490 Unclassified drug
J3590 Unclassified biologic
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
TROGARZOTM is a trademark of TaiMed Biologics Inc., under license to Theratechnologies Inc.
© 2018 Theratechnologies Inc. All rights reserved. 348-01-11/17
Questions?
Contact us at 1-833-23-THERA (1-833-238-4372),
Mon-Fri 8AM-8PM ET
Billing and Coding Guide

Navigation menu