Billing information and codes for ARISTADA INITIO® (aripiprazole lauroxil) and ARISTADA® (aripiprazole lauroxil)
IMPORTANT: Healthcare providers are responsible for keeping current and complying with all applicable coverage requirements and for the selection of diagnosis and procedure codes that accurately reflect their patient’s condition and the services rendered. Healthcare providers also are responsible for the accuracy of all claims and related documentation submitted for reimbursement. Additional insurance requirements may apply and healthcare providers should always contact the insurer directly to obtain complete and current information regarding coverage of ARISTADA and/or ARISTADA INITIO. Alkermes does not guarantee coverage or reimbursement. Under no circumstances will Alkermes, Inc., or its affiliates, employees, consultants, agents or representatives be liable for costs, expenses, losses, claims, liabilities or other damages that may arise from, or be incurred in connection with, the information provided here or any use thereof.
| Billing Information and Codes for ARISTADA INITIO and ARISTADA |
| Field/Category Name | Example - ARISTADA INITIO* | Example - ARISTADA* |
| Procedures, services, or supplies (eg, HCPCS code) | J1943 - injection, aripiprazole lauroxil, (ARISTADA INITIO), 1 mg |
J1944 - injection, aripiprazole lauroxil, (ARISTADA), 1 mg
|
| Procedures, services, or supplies (eg, NDCs) |
ARISTADA INITIO® (aripiprazole lauroxil)
675 mg: NDC 65757-500-03
|
ARISTADA® (aripiprazole lauroxil)
441 mg: NDC 65757-401-03
662 mg: NDC 65757-402-03
882 mg: NDC 65757-403-03
1064 mg: NDC 65757-404-03
|
| Procedures, services, or supplies (eg, CPT® code†) | 96372 therapeutic, prophylactic, diagnostic subcutaneous or intramuscular injection‡ | 96372 therapeutic, prophylactic, diagnostic subcutaneous or intramuscular injection‡ |
| Units | 675 units for 675 mg |
441 units for 441 mg
662 units for 662 mg
882 units for 882 mg
1064 units for 1064 mg
|
| Diagnosis or nature of illness or injury |
F20.0 Paranoid schizophrenia
F20.1 Disorganized schizophrenia
F20.2 Catatonic schizophrenia
F20.3 Undifferentiated schizophrenia
F20.5 Residual schizophrenia
F20.89 Other schizophrenia
F20.9 Unspecified schizophrenia
|
F20.0 Paranoid schizophrenia
F20.1 Disorganized schizophrenia
F20.2 Catatonic schizophrenia
F20.3 Undifferentiated schizophrenia
F20.5 Residual schizophrenia
F20.89 Other schizophrenia
F20.9 Unspecified schizophrenia
|
CPT®=Current Procedural Terminology. CPT® is a registered trademark of the American Medical Association.
*All examples indicated should also include any placeholder digits required by the 837P format.
†This code is not intended to be reported by the physician in the facility setting.
‡ARISTADA INITIO and ARISTADA are only to be administered as an intramuscular injection by a healthcare professional.
Coding decisions should be made by the physician based on an independent review of the patient's condition.
The Coding and Billing Guide contains condensed coding and billing information for ARISTADA and ARISTADA INITIO for physician offices and hospitals.
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