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).
(1200 mg = 120 billing 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:
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
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.