Asceniv (IVIG)
Billing
Code: J1554
Description: Inj. asceniv
Unit: 0.5 g
Payment: $491.405
Pay quarter: Q4 2023
Dosage and Frequency
Calculate drug reimbursement
Total Reimbursement:
$29,484.30(ASP: $27,815.38, Margin: $1,668.92)
Code:
J1554# Units to bill:
60Prior Authorization
Prior auth criteria for Asceniv may include but is not limited to:
1. The patient must have a diagnosis of moderate to severe allergic or inflammatory asthma that is not adequately controlled with a high dose of an inhaled corticosteroid and at least one other controller medication, such as a long-acting beta-agonist (LABA) or a leukotriene receptor antagonist (LTRA).
2. The patient must be at least 12 years old.
3. The patient must be able to use a nebulizer correctly.
4. The patient must have had a pulmonary function test (PFT) within the past year.
5. The patient must have had a trial of at least two other asthma controller medications, including at least one LABA or LTRA, prior to initiating Asceniv.
6. The patient must have had a trial of a high dose of an inhaled corticosteroid prior to initiating Asceniv.
7. The patient must be willing and able to adhere to the treatment plan and follow-up visits.
Insurance prior auth guidelines:
Billable NDCs
69800-0250-01
Asceniv (ADMA BIOLOGICS)
5000 MG
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