Coding for ZARXIO® (filgrastim-sndz)

Be sure the numbers you need are always quickly accessible:

HCPCS1 Codes

Five-digit alpha-numeric codes used to report drugs and other supplies

Physician Office or Hospital Outpatient Setting2:

Q5101—Injection, filgrastim (G-CSF), biosimilar, 1 microgram

CPT3 Codes

Five-digit codes that describe procedures and services performed by physicians and other healthcare providers

Physician Office or Hospital Outpatient Setting4:

96372—Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular

Diagnosis Codes

Numeric classification descriptive of patient conditions accepted by all payers

Physician Office or Hospital Outpatient Setting:

Appropriate ICD-9-CM or ICD-10-CM diagnosis code for the patient’s condition

Allowable diagnosis codes vary by payer. Report the appropriate diagnosis code(s) to describe the patient’s condition. Primary and secondary diagnosis codes may be required.

Use ICD-9-CM code(s) for dates of service prior to October 1, 2015
Use ICD-10-CM code(s) for dates of service on and after October 1, 2015

NDCs*

Universal 11-digit product identifier for human drugs; each NDC identifies the labeler, product, and trade package size

Physician Office or Hospital Outpatient Setting:

Zarxio single-dose pre-filled syringe (PFS), pack of 1 PFS:
61314-0304-01 (300 mcg filgrastim-sndz PFS)
61314-0312-01 (480 mcg filgrastim-sndz PFS)

Zarxio single-dose PFS, pack of 10 PFS:
61314-0304-10 (300 mcg filgrastim-sndz PFS)
61314-0312-10 (480 mcg filgrastim-sndz PFS)

*When reporting the NDC on claims, use the 5-4-2 digit format. Insert a leading zero in the appropriate section to complete the 5-4-2 digit format. Remove the dashes prior to entering the NDC on the claim form.

Contact Sandoz One Source

Phone

  • 1-844-SANDOZ1
  • (1-844-726-3691)
  • M-F 9AM to 8PM ET

Fax

  • 1-844-726-3695

Address

  • PO Box 220188
  • Charlotte, NC 28222-0188

This website provides general information and is not intended to provide reimbursement or legal  advice. Furthermore, it is not intended to increase or maximize payment by any payer. Because laws, regulations, and coverage policies are complex and updated frequently, you should check with your local Medicare carrier and payers often or go to www.cms.gov.

Nothing in the information provided shall be construed as a guarantee of Sandoz regarding levels of  reimbursement, payment, or charge that reimbursement will be received. The ultimate responsibility for obtaining reimbursement lies with the physician, provider, or patient. Please consult with your counsel or reimbursement specialist for any patient-specific reimbursement or billing questions.