Back to drug list

Asceniv (IVIG)


Billing

Code: J1554

Description: Inj. asceniv

Unit: 0.5 g

Payment: $481.770

Pay quarter: Q1 2023


Medicare history

Dosage and Frequency

Calculate drug reimbursement


Total Reimbursement:

$30,640.57

(ASP: $28,906.20, Margin: $1,734.37)


Code:

J1554

# Units to bill:

60

Prior 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



Resources