Billing for the Administration of Onpro®

The new CPT code 96377 Application of on-body injector (includes cannula insertion) for timed subcutaneous injection. became effective January 1, 2017.

Certain commercial payors are paying on CPT 96377. 

However, CMS assigned this new code Status Indicator "I" (inactive) on the Medicare Physician Fee Schedule. As the status indicator is determined by CMS, individual Medicare contractors have no discretion to alter such a status.  

Although individual Medicare contractors can price the code (and many did quite a while ago), they cannot pay it. Any claim submitted with 96377 will be rejected since that is an invalid code.  

Last year, when this drug was first marketed packaged with the disposable pump, Noridian suggested to providers to bill as they usually would with the appropriate subcutaneous injection code, 96372. Noridian Medical Director, Richard Whitten, has confirmed that providers may bill for the administration of Neulasta® (pegfilgrastim) Onpro® with CPT 96372.

Below is a link to Noridian's current policy on billing for J2505  

In light of this information from Noridian, providers may want to correct claims filed with the denied CPT 96377 using CPT 96372 in its place. 


The Centers for Medicare & Medicaid Services (CMS) has assigned a permanent Healthcare Common Procedure Coding System (HCPCS) code specific to IMLYGIC (talimogene laherparepvec).

The new code, J9325, is defined as injection, talimogene laherparepvec, per 1 million plaque forming units (PFU). This code is effective January 1, 2017. 

New HCPCS Code for Portrazza® (necitumumab)

Effective January 1, 2017 there is a a product‐specific Healthcare Common Procedure Coding System (HCPCS) code forPortrazza® (necitumumab) for injection.

The new code, J9295, is defined as “injection, necitumumab, 1 mg.” This code is effective January 1, 2017. 

2017 Highlights of ASH Series – Registration Open!

Registration is now open for the 2017 Highlights of ASH in North America series. 

As a partner in this event WSMOS is pleased to announce that WSMOS members are entitled to receive discounted registration (to the ASH Member rate). 

If you were unable to make it to this year’s ASH Annual Meeting, attend one of five Highlights programs throughout the US to hear a comprehensive review of the latest scientific findings and treatment strategies that was presented in San Diego earlier this month! 

Click on the link below for registration and program information.  The 2017 Highlights of ASH in North America series will take place in the following locations:

·         Highlights of ASH in North America

o    January 13-14:  Atlanta

o    January 20-21:  Chicago and Dallas

o    January 27-28:  New York and Seattle


New FDA Approval for Genentech's TECENTRIQ®

Genentech is excited to share the news of a new FDA approval. TECENTRIQ® (atezolizumab) is NOW FDA APPROVED for the treatment of patients with previously treated metastatic non-small cell lung cancer (NSCLC) who have disease progression during or following platinum-containing chemotherapy. Patients with EGFR or ALK genomic tumor aberrations should have disease progression on FDA-approved therapy for these aberrations prior to receiving TECENTRIQ.

Click Here for the full Prescribing Information.

Click Here for more information including NDC and ICD-10 codes. 

New Labeling Approved for XTANDI

On October 21, 2016, Astellas Pharma Inc. and Pfizer Inc. announced the U.S. Food and Drug Administration (FDA) approved a supplemental New Drug Application (sNDA) to update the U.S. product labeling for XTANDI® (enzalutamide) capsules to include new clinical data versus bicalutamide from the TERRAIN study. The data demonstrate improvement in radiographic progression-free survival (rPFS) in patients with metastatic castration-resistant prostate cancer (CRPC) who were treated with enzalutamide compared to patients who were treated with bicalutamide.

Click Here for the XTANDI Clinical Launch Announcement. 

New FDA approval for LARTRUVO™ (olaratumab)

On October 19, 2016, the US Food and Drug Administration (FDA) approved LARTRUVO™ (olaratumab) injection, 10 mg/mL solution. LARTRUVO is indicated, in combination with doxorubicin, for the treatment of adult patients with soft tissue sarcoma (STS) with a histologic subtype for which an anthracycline-containing regimen is appropriate and which is not amenable to curative treatment with radiotherapy or surgery.

This indication is approved under accelerated approval. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trial.

Click here for full Prescribing Information and see below for Important Safety Information for LARTRUVO.

KEYTRUDA Receives New Approval for mNSCLC

Merck is pleased to announce that KEYTRUDA is now the only anti–PD-1 approved for first-line treatment of mNSCLC with high PD-L1 expression (TPS ≥50%). In the KEYNOTE-024 study, KEYTRUDA demonstrated superior survival in the first-line treatment  of mNSCLC vs platinum-containing chemotherapy in patients whose tumors expressed high levels of PD-L1 (TPS ≥50%).

For more information:

Click Here to read the Press Release

Click Here to read the Announcement Letter

KEYTRUDA Prescribing Information

KEYTRUDA Medication Guide