FACILITATING COVERAGE AND CODING

This information is intended to provide an overview of MONJUVI coding and coverage information. It does not guarantee payment or coverage for any product or service.

Effective April 1, 2021, MONJUVI has a unique J-Code

J9349:Injection, tafasitamab-cxix, 2 mg

Payer requirements regarding detailed claim form information may vary. It is important to check with individual payers on their specific requirements, especially as related to units of measurement.

MONJUVI J-Code billing unit conversion

J9349 Billing Unit

2 mg

1 Single-Dose Vial or MONJUVI

200 mg

200 mg Vial

100 Units

The total number of mg administered will vary based on patient weight.

What can I do to support timely reimbursement of MONJUVI claims?

Follow the payer’s policy information regarding MONJUVI coverage requirements:

  1. Prior Authorization
  2. Patient medical history and prior treatments
  3. Other supporting clinical information

When completing the 1450 or 1500 Claims Form, use the MONJUVI specific J-Code: J9349 (Injection, tafasitamab-cxix, 2 mg).

Include correct number of units administered

  1. E.g., One 200 mg vial is equal to 100 units
  2. Separately, use the JW modifier to report discarded units as required

Ensure accuracy of the following information needed to process the claim:

  1. CPT Code
  2. Patient Diagnosis and information
  3. Correct NDC Format (Payers typically require the 11-digit format)
  4. Prior Authorization Number (if applicable)

Check your payer agreements to ensure you understand any specific reimbursement needs for MONJUVI

Make sure electronic claims are successfully submitted.

The information herein is provided for educational purposes only. Insurance coverage and reimbursement are not guaranteed. Coverage and reimbursement may vary significantly by payer, plan, patient, and setting of care. It is the sole responsibility of the health care provider to select the proper codes and ensure the accuracy of all statements used in seeking coverage and reimbursement for an individual patient.

For billing and coding or reimbursement questions, or to request support from a member of the field access and reimbursement team, call (855) 421-6172, Monday to Friday 8 am to
8 pm ET.

For information on MONJUVI coding and billing requirements, provider readiness and sample forms,
please download the MONJUVI Billing & Coding Guide.