|Coding Information for FENSOLVI
|NDC for FENSOLVI
|N462935016360 (for billing purposes)
|HCPCS Code for FENSOLVI
|Injection, leuprolide acetate for depot suspension, 0.25 mg
CMS has established a new, permanent Healthcare Common Procedure Coding System (HCPCS) code for FENSOLVI® (leuprolide acetate) for injectable suspension, effective July 1, 2021. After July 1, 2021, FENSOLVI should be reported with J1951, and this code should replace any miscellaneous codes previously used, such as J3490. As insurance companies and Medicaid offices update their codes at different times, the existing miscellaneous code, such as J3490, may still need to be utilized until J1951 gets incorporated in respective systems.
Click the image below to download our coding reference guide for examples of how to properly enter the drug codes on common claim forms:
It is strongly recommended that you contact the patient’s insurance company for clarification on coding instructions.
Tolmar does not guarantee coverage or payment. The healthcare provider should follow all billing and coding requirements established by the insurance company to submit compliant claims for FENSOLVI. All codes on the claim form should be supported by the documentation in the patient’s medical record.
Questions on J-code related billing? Please email your questions to firstname.lastname@example.org