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: 02101 (AK), 02201 (ID), 02301(OR), 02401 (WA), 03101 (AZ), 03201 (MT), 03301 (ND), 03401 (SD), 03501 (UT) and 03601 (WY).

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 Oct 14, 2019