Portrazza® (necitumumab)

Update your billing and coding systems to include the permanent CYRAMZA® (ramucirumab) J-code: J9308, injection, ramucirumab, 5 mg. Issued by the Centers for Medicare & Medicaid Services (CMS), this permanent J-code is effective as of January 1, 2016.

Portrazza® (necitumumab)

Services

Patients who are prescribed Portrazza for an FDA-approved indication may be eligible for reimbursement services, financial assistance, or product through the Lilly Cares Foundation.*

The Lilly Cares Foundation, Inc., a separate nonprofit organization, provides free Lilly medications to qualifying patients. Lilly PatientOne collects information on behalf of Lilly Cares to assist Lilly Cares with its charitable mission. For more information about Lilly Cares, please visit LillyCares.com.

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Billing Information Ordering Information
HCPCS Codes
Code Description Setting
J9295 Injection, necitumumab (billing unit = 1 mg) Physician office
C9475 Injection, necitumumab (billing unit = 1 mg) Hospital outpatient
NDC
Code Dosage form and strength
00002-7716-01 Portrazza (necitumumab for injection) 800 mg/50 mL vial
Diagnosis Codes
Non-small cell lung cancer
ICD-10 Code Description
Malignant neoplasm of trachea, bronchus, and lung
C33 Trachea
C34.00 Unspecified main bronchus
C34.01 Right main bronchus
C34.02 Left main bronchus
C34.10 Upper lobe, unspecified bronchus or lung
C34.11 Upper lobe, right bronchus or lung
C34.12 Upper lobe, left bronchus or lung
C34.2 Middle lobe, bronchus or lung
C34.30 Lower lobe, unspecified bronchus or lung
C34.31 Lower lobe, right bronchus or lung
C34.32 Lower lobe, left bronchus or lung
C34.80 Overlapping sites of unspecified bronchus and lung
C34.81 Overlapping sites of right bronchus and lung
C34.82 Overlapping sites of left bronchus and lung
C34.90 Unspecified part of unspecified bronchus or lung
C34.91 Unspecified part of right bronchus or lung
C34.92 Unspecified part of left bronchus or lung
Drug Administration CPT® Codes
Code Description
96413 Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour

Lilly has contracted with a network of specialty distributors and one specialty pharmacy to provide customers access to Portrazza.

If purchasing Portrazza directly, you may use one of the five specialty distributors listed here. You also have the option of ordering from our authorized specialty pharmacy partner shown below. For more information on purchasing, dispensing, or returning Lilly products, visit LillyTrade.com. For inquiries about this matter, contact Lilly at 1-800-LillyRx (1-800-545-5979).

Specialty Distributor Network
AmerisourceBergen Specialty Group
Order Entry Code: 500 mg/50 mL - 45884
Oncology Supply ASD Healthcare
P: (800) 633-7555, F: (800) 248-8205
oncologysupply.com
P: (800) 746-6273, F: (800) 547-9413
asdhealthcare.com
Cardinal Health Specialty Pharmaceutical Distribution
Order Entry Code: 500 mg/50 mL - 5203856
Oncology Clinics Hospitals
P: (855) 740-1871, F: (888) 345-4916
cardinalhealth.com
/specialtyonline
P: (866) 476-1340, F: (888) 345-4916
cardinalhealth.com
/specialtyonline
CuraScript Specialty Distribution
Order Entry Code: 268321
P: (877) 599-7748, F: (800) 862-6208, curascriptsd.com
McKesson Specialty Care Distribution Corporation
Order Entry Code: 500 mg/50 mL - 5005803
McKesson Specialty Health McKesson Plasma and Biologics
P: (800) 482-6700, F: (800) 289-9285
mscs.mckesson.com
P: (877) 625-2566, F: (888) 752-7626
connect.mckesson.com
Smith Medical Partners
Order Entry Code: 500 mg/50 mL - 5525472
P: (800) 292-9653, F: (630) 227-9220, smpspecialty.com
Authorized Specialty Pharmacy
Biologics Inc.
P: (800) 850-4306, F: (800) 823-4506, biologicsinc.com

Prescribing Information including BOXED WARNINGS

This information is presented for informational purposes only and is not intended to provide reimbursement or legal advice. Laws, regulations, and policies concerning reimbursement are complex and are updated frequently. Individual coding decisions should be based upon diagnosis and treatment of individual patients. Eli Lilly and Company does not guarantee success in obtaining insurance payments. While we have made an effort to be current as of the issue date of this website, the information may not be as current or comprehensive when you view it. Providers should contact third-party payers for specific information on their coverage, coding, and payment policies. Please consult with your legal counsel or reimbursement specialist for any reimbursement or billing questions. For more information please call the Lilly PatientOne program at 1-866-472-8663.

† FDA standard NDC has been “zero-filled” to ensure creation of an 11-digit code that meets HIPAA standards. The zero-fill location is indicated in bold.