Kymriah (tisagenlecleucel)
Billing
Code: Q2042
Description: N/A
Unit: N/A
Payment: Claims for Q2042 must be manually adjudicated
Pay quarter: N/A
Dosage and Frequency
B-cell precursor acute lymphoblastic leukemia (ALL)
• 0.2 to 5.0 x 10^6 CAR-positive viable T cells per kg IV if patient weighs 50kg or below
• 0.1 to 2.5 x 10^8 CAR-positive viable T cells IV if patient weighs above 50kg
• 0.2 to 5.0 x 10^6 CAR-positive viable T cells per kg IV if patient weighs 50kg or below
• 0.1 to 2.5 x 10^8 CAR-positive viable T cells IV if patient weighs above 50kg
Calculate drug reimbursement
Total Reimbursement:
N/A(ASP: N/A, Margin: N/A)
Code:
Q2042# Units to bill:
N/APrior Authorization
Prior auth criteria for Kymriah may include but is not limited to:
Insurance prior auth guidelines:
Billable NDCs
Resources