ICD-10 Codes
- Benefits Investigation FormA way to find out if DARZALEX FASPRO® is covered by the patient's insurance plan, including requirements for coverage or prior authorization, any out-of-pocket costs, and approved pharmacies.
- Bulk Benefits Investigation GuideLearn how to submit requests for multiple patients at once in the Provider Portal.
- Business Associate AgreementComplete a Business Associate Agreement for your practice only once. No individual patient authorizations are required.
- Coding & Billing in Hospital Outpatient Departments GuideCoding information to support access & reimbursement for DARZALEX FASPRO®.
- Coding & Billing in Physician Office GuideCoding information to support access & reimbursement for DARZALEX FASPRO®.
- Exception Considerations ChecklistA guide to submitting a formulary exception request.
Exception Considerations Checklist (en español) - Janssen CarePath Resource GuideA comprehensive summary of support tools for your office to help patients start and stay on treatment.
- Letter of ExceptionA template that you can fill out and submit to a patient’s health insurance provider asking them to cover a medication that is not on formulary.
- Letter of Medical NecessityA template that you can fill out and submit to a patient’s health insurance provider. You may use it to explain why DARZALEX FASPRO® is medically necessary for your patient.
- Patient Account Overview
- Patient Affordability OptionsDiscover options that can make DARZALEX FASPRO® more affordable for your patients.
- Patient Authorization FormIndividual patient form for offices without a Business Associate Agreement.
Patient Authorization Form (en español) - Patient Authorization Form (en español)Individual patient form for offices without a Business Associate Agreement.
- Prior Authorization Considerations ChecklistA checklist to guide you through the prior authorization process.
Prior Authorization Considerations Checklist (en español) - Reimbursement & Access GuideA comprehensive summary of important medication information including uses, Important Safety Information, access, and reimbursement.
- Savings Program (Overview)Eligible patients using commercial or private insurance can save on out-of-pocket costs for DARZALEX FASPRO®.
- Savings Program Assignment of Benefits FormA form the patient can submit that allows Janssen CarePath Savings Program to reimburse the provider directly.
- Verification of Benefits Guide (Medical)A guide to understanding the Verification of Benefits for your patient’s medical benefits.
- Verification of Benefits Guide (Pharmacy)A guide to understanding the Verification of Benefits for your patient’s pharmacy benefits.

ICD-10 Codes
Click below to see the ICD-10 codes.
Click Below to See the Codes
C90.0 Multiple Myeloma
TIP: Do not assign an additional code for bone metastasis (C79.51) when multiple myeloma is described as metastatic to the bone; bone involvement is integral to this disease process.
ICD-10 Indication | ICD-10 Code |
Multiple myeloma not having achieved remission | C90.00 |
|
|
|
|
Multiple myeloma in remission | C90.01 |
Multiple myeloma in relapse | C90.02 |
*not otherwise specified
E85 Amyloidosis
ICD-10 Indication | ICD-10 Code |
Light chain (AL) amyloidosis | E85.81 |
Collected in 10/21 and may change.
This information is not a promise of coverage or payment. It is not intended to give reimbursement advice or increase reimbursement by any payer. Legal requirements and plan information can be updated frequently. Contact the plan for more information about current coverage, reimbursement policies, restrictions, or requirements that may apply.
For more information on ICD-10, visit the CMS website.
SOURCE
ICD-10-CM 2022: The Complete Official Codebook. American Medical Association, 2021.