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J-code/Drug codes

J-code/Drug codes

Coding Information for FENSOLVI
NDC for FENSOLVI N462935016360 (for billing purposes)
HCPCS Code for FENSOLVI J1951
J-code descriptions Injection, leuprolide acetate for depot suspension, 0.25 mg
Billable Unit 0.25 mg
Units 180

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 fensolvi@tolmar.com

IMPORTANT SAFETY INFORMATION

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FENSOLVI (leuprolide acetate) for injectable suspension is a gonadotropin releasing hormone (GnRH) agonist used to treat patients 2 years of age and older with central precocious puberty (CPP). CPP may be diagnosed when signs of sexual maturity begin to develop in girls under the age of 8 or in boys under the age of 9.

FENSOLVI is contraindicated in individuals with hypersensitivity to any drug that is in the same class as FENSOLVI, in individuals who are allergic to any of the ingredients in FENSOLVI, or in individuals who are pregnant. FENSOLVI may cause fetal harm when administered to a pregnant patient.

During the first few weeks of treatment, increases in gonadotropins and sex steroids above baseline may result in an increase in signs and symptoms of puberty including vaginal bleeding in girls.

Psychiatric events have been reported in patients taking GnRH agonists. Events include emotional lability, such as crying, irritability, impatience, anger, and aggression. Patients should be monitored for development or worsening of psychiatric symptoms.

Convulsions have been observed in patients treated with GnRH agonists with or without a history of seizures, epilepsy, cerebrovascular disorders, central nervous system anomalies or tumors, and in patients on concomitant medications that have been associated with convulsions such as bupropion and SSRIs.

Pseudotumor Cerebri (Idiopathic Intracranial Hypertension) has been reported in pediatric patients treated with GnRH agonists.  Patients should be monitored for headache, papilledema and blurred vision.

The most common adverse events seen with FENSOLVI were: injection site pain, nasopharyngitis, pyrexia, headache, cough, abdominal pain, injection site erythema, nausea, constipation, vomiting, upper respiratory tract infection, bronchospasm, productive cough and hot flush. 

Please see Full Prescribing Information for FENSOLVI for additional important safety information. 

To report suspected adverse reactions contact Tolmar at 1-844-4TOLMAR (486-5627) or the FDA at 1-800-FDA-1088 or visit www.fda.gov/medwatch.