ACCESS & SUPPORT

Billing & Reimbursement

Please note: The coding, coverage, reimbursement, and related information presented on this page is from various third-party sources and is subject to change without notice. GSK cannot guarantee the accuracy or timeliness of these data. This information should not be considered a guarantee of success in obtaining third-party insurance payment for any product and should not be relied upon without payer confirmation. The decision by a payer to pay for a specific product is based on many factors. It is always the prescriber’s responsibility to determine the appropriate treatment and submit appropriate codes, charges, and modifiers for treatments provided. Providers should contact third-party payers for specific information on their policies.

EXDENSUR J-code

J2361

Injection, depemokimab-ulaa, 1 mg  

Coding Quick Reference Tables

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Codes for physician offices prescribing EXDENSUR for in-office administration

NDC Description
0173-0927-42 100 mg/mL, single-dose, prefilled syringe with attached 29-gauge, half-inch needle with a needle guard in cartons of 1
Procedure (CPT®) Description
96372 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); SC or IM
96401 Chemotherapy administration, SC or IM; non-hormonal anti-neoplastic
CPT is a registered trademark of the American Medical Association (AMA). The AMA has recognized the use of the 96401 administration code for some non-chemotherapy substances, such as certain monoclonal antibody agents and other biologic response modifiers. Since EXDENSUR is a human monoclonal antibody agent, this CPT code may be applicable. However, recognition of chemotherapy administration codes for non-chemotherapy drugs may vary by payer, and the documentation must support the use of these codes.
Modifiers Description
JZ Zero drug amount discarded/not administered to any patient
Diagnosis (ICD-10-CM) Severe Asthma
J45.50 Severe persistent asthma, uncomplicated
J45.51 Severe persistent asthma with (acute) exacerbations. X=0 uncomplicated, X=1 with exacerbations
J82.83 Eosinophilic asthma
CPT®=Current Procedural Terminology; ICD-10-CM=International Classification of Diseases, Tenth Revision, Clinical Modification; IM=intramuscular; NDC=National Drug Code; SC=subcutaneous.

More to explore:

Access & Support

Find support materials and insurance information to help your patients access EXDENSUR.

Confidence with in-office administration

In-office administration allows you to confidently deliver 6 months of therapy with every subcutaneous (SC) injection.

Indication & Safety Info

Indication

Important Safety Information

Indication

EXDENSUR is indicated for the add-on maintenance treatment of severe asthma, characterized by an eosinophilic phenotype, in adult and pediatric patients aged 12 years and older. EXDENSUR is not indicated for the relief of acute bronchospasm or status asthmaticus.

Important Safety Information

WARNINGS AND PRECAUTIONS

Hypersensitivity Reactions
Hypersensitivity reactions, including anaphylaxis, can occur following administration of EXDENSUR. If a hypersensitivity reaction occurs, discontinue EXDENSUR and initiate appropriate therapy.

Acute Asthma Symptoms or Deteriorating Disease
EXDENSUR should not be used to treat acute asthma symptoms or acute exacerbations.

Risk Associated with Abrupt Reduction of Corticosteroid Dosage
Upon initiation of EXDENSUR therapy, do not abruptly discontinue systemic or inhaled corticosteroids. Reductions in corticosteroid dose, if appropriate, should be gradual and under the supervision of a healthcare provider. Reduction in corticosteroid dose may be associated with systemic withdrawal symptoms and/or unmask conditions previously suppressed by systemic corticosteroid therapy.

Parasitic (Helminth) Infection
Patients with pre-existing helminth infections should be treated for their infection prior to initiation of EXDENSUR therapy. If patients become infected while receiving EXDENSUR and do not respond to anti-helminth treatment, discontinue EXDENSUR until the infection resolves.

ADVERSE REACTIONS

In patients receiving EXDENSUR, the most common adverse reactions (≥4%) were upper respiratory tract infection, allergic rhinitis, influenza, arthralgia, and pharyngitis. Injection site reactions have also occurred. 

USE IN SPECIFIC POPULATIONS

The data in pregnant women are insufficient to identify a drug-associated risk of major birth defects, miscarriage, or other adverse maternal or fetal outcomes. Transport of endogenous IgG antibodies and monoclonal antibodies, such as depemokimab-ulaa, across the placenta increases as pregnancy progresses and peaks during the third trimester.

EXDENSUR can cross the placenta during pregnancy and the presence of the YTE modification may prolong and increase exposure to the infant exposed in utero. The impact of transmission to the fetus should be considered. Pregnant women exposed to EXDENSUR, or their healthcare providers, should report EXDENSUR exposure by calling 1-888-825-5249.

Please see full Prescribing Information for EXDENSUR.

To report SUSPECTED ADVERSE REACTIONS, contact GSK at gsk.public.reportum.com or 1-888-825-5249, or
FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.