Helsinn Cares AKYNZEO® Reimbursement and Access Support Resources
Patient Access Support for Healthcare Professionals
The Helsinn Cares program is designed to provide AKYNZEO® patient assistance and resources for AKYNZEO® reimbursement, and to help you and your office staff focus on patient care.
To help your patients with AKYNZEO® affordability, start the process by enrolling your patients in Helsinn Cares today!
When you enroll your patients in Helsinn Cares, the program can help with confirming benefit coverage and facilitate prior authorizations or appeals, when required. And, if your patient meets eligibility criteria, then he or she will be considered for the Patient Assistance Program, which provides AKYNZEO® savings for patients.
Billing and Coding for AKYNZEO® Capsules
|HCPCS Level III Code|
|J8655||Netupitant 300 mg and Palonosetron 0.5 mg, oral|
|When billing for certain drugs, payers require physicians to indicate on the claim form the quantity of product administered to the patient, expressed in the number of units described by the HCPCS code. Report 1 unit of J8655 for one AKYNZEO® capsule.|
|ICD-10-CM Diagnosis Codes|
|R11.2||Nausea with vomiting, unspecified|
|R11.11||Vomiting without nausea|
|National Drug Codes (NDC)|
|AKYNZEO® Package Size||NDC|
|Single-dose capsule: 300 mg netupitant/0.5 mg palonosetron||69639-101-01|
|Pack of four capsules (two capsules per blister strip): 300 mg netupitant/0.5 mg palonosetron||62856-101-04|
|Some payers require providers to report 11-digit NDCs when reporting a drug on a claim form. Converting the 10-digit NDC for AKYNZEO® to an 11-digit NDC requires the use of a leading zero in the product code section of the AKYNZEO® NDC (ie, the middle section).|
|ICD-10-CM Supplementary Classification Codes|
|ICD-10-CM Supplementary Classification Code||Description|
|T45.1X5||Adverse effect of antineoplastic and immunosuppressive drugs|
|Z41.8||Encounter for other procedures for purposes other than remedying health state|
|Z51.11||Encounter for antineoplastic chemotherapy|
|Providers should use current ICD-10-CM diagnosis codes to report a patient’s diagnosis on claim submissions. Please check with the payer to verify coding or special billing requirements.|
Get the Billing and Coding Guide for AKYNZEO® capsules here. Download Guide
Helsinn Cares provides tools — for you and your
patients — to support reimbursement and access to AKYNZEO®.
Helsinn is committed to helping every patient obtain the Helsinn medication he or she needs. For answers to specific questions, please call 1‑84HELSINN‑U (1‑844‑357‑4668), select prompt 1 for medical information; select prompt 2 for Helsinn Cares.