Billing and Coding Guidelines: Truxima (rituximab-abbs)

The Billing and Coding Guidelines: Truxima (rituximab-abbs) coverage article has been created and published for notice under contract numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, NMI) and 01312 (NV).

Effective Date: July 1, 2019
Article Summary:

  • Noridian covers Truxima® (rituximab-abbs) only for the FDA approved labeled indications listed below.
    • Relapsed or refractory, low grade or follicular, CD20-positive B-cell NHL as a single agent
    • Previously untreated follicular, CD20-positive, B-cell NHL in combination with first line chemotherapy and in patients achieving a complete or partial response to a rituximab product in combination with chemotherapy, as single-agent maintenance therapy
    • Non-progressing (including stable disease), low-grade, CD20-positive, B-cell NHL as a single agent after first-line cyclophosphamide, vincristine and prednisone (CVP) chemotherapy
  • Contains billing instructions for C9399 with dates of service between 11/28/18 and 06/30/2019. Effective 07/01/2019, Q5115 is to be used by all facilities when billing this drug

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            Last Updated Wed, 16 Oct 2019 15:16:04 +0000