BENLYSTA Gateway can provide information about relevant codes for BENLYSTA, including product codes, procedure codes, NDC numbers, and revenue codes.
Hospital outpatient department
As with coding for services performed in the physician’s office, coding preferences and requirements in the hospital outpatient setting are dependent on payer type and plan type. BENLYSTA Gateway can help identify coding requirements in both settings.
Appeals research support
If a patient is denied coverage for BENLYSTA, BENLYSTA Gateway is available to research instances of coverage denial and identify steps practices can take to appeal claims. BENLYSTA Gateway cannot author appeal letters on behalf of physicians. See sample letter of appeal below.
Sample forms and letters
When BENLYSTA is accessed throughout the patient treatment journey, a practice or hospital outpatient department may encounter the need for information on Centers for Medicare & Medicaid Services (CMS) Claim Form 1500, as well as appeal letters and letters of medical necessity. Details and examples of each are provided below.