BENLYSTA Patient
BENLYSTA Patient

BENLYSTA BILLING AND
CODING GUIDE

A summary of access and reimbursement details to help support you and your practice.

Find helpful information on BENLYSTA codes and ICD-10 descriptions on this page.

Find helpful information on BENLYSTA codes and ICD-10 descriptions on this page.

BENLYSTA CODES
AND DESCRIPTIONS

BENLYSTA billing and coding requirements may vary based on factors such as where the drug is administered, the type of insurance the patient has, and the patient’s status and medical history.

Below is a Billing and Coding Quick Reference Guide for BENLYSTA.

Use of the codes below does not guarantee reimbursement.

BENLYSTA Billing and Coding Reference Guide
BENLYSTA Billing and Coding Reference Guide

* The American Medical Association (AMA) has recognized the use of the 96413 administration code for some non-chemotherapy substances, such as certain monoclonal antibody agents and other biologic response modifiers. Since BENLYSTA 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.

† The coding, coverage, reimbursement, and related information presented in this guide 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 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.

BENLYSTA Coding Guide
BENLYSTA Coding Guide

Reference: 1. Medicare Coverage Database. CMS.gov. Accessed February 22, 2021.

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