This site is intended for U.S. health care professionals only.

Healthcare Common Procedure Coding System

The following are the ORBACTIV® (oritavancin) drug codes and billing units for appropriate billing. Medicare, private payers, and state Medicaid programs require UB-04 (CMS-1450) claim forms (for Hospital Outpatient setting) or CMS-1500 (for Freestanding Infusion Center setting) to report the following codes and amount of product used to facilitate appropriate reimbursement.

The following are the billing units for ORBACTIV® (oritavancin).

Settings
HCPCS
Billing Description
2022 Q1 Medicare Payment Rates
Hospital Outpatient§
J2407
Injection, oritavancin, 10 mg
120 units
(1200 mg = 120 billing units)
Freestanding Infusion Centers and Physician Offices§
J2407
Injection, oritavancin, 10 mg
120 units
(1200 mg = 120 billing units)

§ Please note: Other payors may require different billing units. Please follow payor guidance.

Accurate reporting of the ORBACTIV® HCPCS code, as well as the quantity administered to each patient, is required for appropriate reimbursement. When completing a UB-04/ CMS 1450 or CMS 1500 form for ORBACTIV®, payers may also require the following information: 

Drug Name
ORBACTIV® (oritavancin) for injection
Route of Administration
By intravenous infusion over 3 hours
Quantity Administered
1200 mg
Dose of Product
1200 mg
NDC

70842-140-01 ORBACTIV® single use 50 mL capacity vial of lyophilized powder containing 400 mg of oritavancin

70842-140-03 Three vials are packaged in a carton to supply for a single 1200 mg dose treatment

Packaging (e.g., single-dose vial)
Three vials packaged in a carton to supply for a single 1200 mg dose treatment

Some payers may also require prescribing information, FDA-approval letter, support of medical necessity and a drug purchase invoice.

For more information regarding Billing and Coding, please click here

DISCLAIMER

Content provided for informational purposes only. This information does not guarantee coverage or payment. Codes, coverage, and payment may vary from setting to setting, and from insurer to insurer. The provider submitting a claim is solely responsible for the accuracy of the codes submitted and for compliance with all coverage and reimbursement policies.

Decisions to prescribe ORBACTIV® are by providers working with their patients. The ORBACTIV® Support Program provides information about ORBACTIV® and about assistance that may be available to patients who meet certain criteria, including that they are not insured by a federal health care program. More information is available through the ORBACTIV® Support Program.

Melinta Therapeutics, Inc. does not guarantee, and assumes no responsibility for the quality, availability, or scope of the ORBACTIV® Support Program services. Melinta Therapeutics, Inc. reserves the right to rescind, revoke, or amend this offer at any time without notice. Void where prohibited by law.

INDICATION AND USAGE

ORBACTIV® (oritavancin) for injection is indicated for the treatment of adult patients with acute bacterial skin and skin structure infections (ABSSSI) caused or suspected to be caused by susceptible isolates of the following gram-positive microorganisms: Staphylococcus aureus (including methicillin-susceptible [MSSA] and -resistant [MRSA] isolates), Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus dysgalactiae, Streptococcus anginosus group (includes S. anginosus, S. intermedius, and S. constellatus), and Enterococcus faecalis (vancomycin-susceptible isolates only).

To reduce the development of drug-resistant bacteria and maintain the effectiveness of ORBACTIV® and other antibacterial drugs, ORBACTIV® should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria.

Important Safety Information

Contraindications

Use of intravenous unfractionated heparin sodium is contraindicated for 120 hours (5 days) after ORBACTIV® administration because the activated partial thromboplastin time (aPTT) test results may remain falsely elevated for approximately 120 hours (5 days) after ORBACTIV® administration.

ORBACTIV® is contraindicated in patients with known hypersensitivity to oritavancin products.

Warnings and Precautions

Coagulation test interference: Oritavancin has been shown to artificially prolong aPTT for up to 120 hours and may prolong PT and INR for up to 12 hours, and ACT for up to 24 hours. Oritavancin has also been shown to elevate D-dimer concentrations up to 72 hours. For patients who require aPTT monitoring within 120 hours of oritavancin dosing, consider a non-phospholipid dependent coagulation test such as a Factor Xa (chromogenic) assay or an alternative anticoagulant not requiring aPTT.

Serious hypersensitivity reactions, including anaphylaxis, have been reported with the use of oritavancin products, including ORBACTIV®. Discontinue infusion if signs of acute hypersensitivity occur. Closely monitor patients with known hypersensitivity to glycopeptides.

Infusion Related Reactions: Administer ORBACTIV® over 3 hours to minimize infusion-related reactions. Infusion reactions characterized by chest pain, back pain, chills and tremor have been observed with the use of oritavancin products (e.g. ORBACTIV®), including after the administration of more than one dose of oritavancin during a single course of therapy. Stopping or slowing the infusion may result in cessation of these reactions.

Clostridioides difficile-associated diarrhea: Evaluate patients if diarrhea occurs.

Concomitant warfarin use: Oritavancin has been shown to artificially prolong PT/INR for up to 12 hours. Patients should be monitored for bleeding if concomitantly receiving ORBACTIV® and warfarin.

Osteomyelitis: Institute appropriate alternate antibacterial therapy in patients with confirmed or suspected osteomyelitis.

Prescribing ORBACTIV® in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of development of drug-resistant bacteria.

Adverse Reactions

The most common adverse reactions (≥3%) in patients treated with ORBACTIV® were headache, nausea, vomiting, limb and subcutaneous abscesses, and diarrhea.

Please see Full Prescribing Information for ORBACTIV®.

INDICATION AND USAGE

ORBACTIV® (oritavancin) for injection is indicated for the treatment of adult patients with acute bacterial skin and skin structure infections (ABSSSI) caused or suspected to be caused by susceptible isolates of the following gram-positive microorganisms: Staphylococcus aureus (including methicillin-susceptible [MSSA] and -resistant [MRSA] isolates), Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus dysgalactiae, Streptococcus anginosus group (includes S. anginosus, S. intermedius, and S. constellatus), and Enterococcus faecalis (vancomycin-susceptible isolates only).

To reduce the development of drug-resistant bacteria and maintain the effectiveness of ORBACTIV® and other antibacterial drugs, ORBACTIV® should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria.