Resources

Reimbursement Links

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.

Resources

Reimbursement Links

Get instant access to the information you need.

To help with any research you might need, we’ve gathered some of the top online resources for coding, coverage, and reimbursement information and placed them at your fingertips. Of course, a Lilly PatientOne representative is always available to help answer your questions or suggest additional resources at 1-866-4PatOne (1-866-472-8663).

Links to helpful resources

Oplinc is a national organization dedicated to preserving patients’ access to cancer services through education and communication between those involved in the delivery of quality cancer care.

Lilly Cares Foundation

The Lilly Cares Foundation, Inc., a separate nonprofit organization, provides free Lilly medications to qualifying patients.

Coding

American Medical Association: CPT® Current Procedural Terminology

A resource maintained by the CPT Editorial Panel to help you better understand the latest CPT codes and coding issues.

HCPCS (Healthcare Common Procedure Coding System) Codes: CMS

The Centers for Medicare & Medicaid Services (CMS) provide a website with coding and process information as well as modifications you should know about.

HCPCS Files: CMS

A downloadable PDF with Level II alphanumeric HCPCS procedure and modifier codes, their long and short descriptions, and applicable Medicare administrative, coverage, and pricing data.

Place of Service Codes for Professional Claims: CMS

Download the Medicare Claims Processing Manual Chapter 26: Completing and Processing Form CMS-1500 Data Set.

ICD-9-CM Diagnosis Coding: CMS Official Coding Guidelines

Information on ICD-9-CM including updates, process for requesting a new/revised code, a downloadable file of diagnosis and treatment codes, and more.

ICD-10-CM: Guidelines, Codes, and Descriptions

Details on the new diagnosis coding system, ICD-10-CM, developed as a replacement for ICD-9-CM.

National Correct Coding Initiative (CCI): CMS

Downloadable PDFs explaining how to use the National Correct Coding Initiative tools.

Coverage

Medicare National and Local Coverage Decisions: CMS

Search and view data from the Medicare Coverage Database, which contains all National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs), local articles, and proposed NCD decisions.

Reimbursement

Medicare Physician Fee Schedule (Look Up Allowables by State and Code): CMS

Search by type of information, Healthcare Common Procedure Coding System (HCPCS) Criteria, Carrier/Medicare Administrative Contractor (MAC), and more.

Medicare Part B Average Sales Price Drug Pricing Files for Physicians

Manufacturer reporting of Average Sales Price (ASP) data and ASP Drug Pricing Files.

Hospital Outpatient Information

Helpful links, resources, and downloads for Hospital Outpatient Prospective System Rulemaking.

Medicare Clinical Lab Fee Schedules: CMS

Information on the clinical laboratory fee schedule, regulations, notices, citations, and more.