This information is intended for U.S. healthcare professionals and/or
healthcare professionals involved in healthcare reimbursement.
This site is intended for U.S. residents 18 years of age or older.
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Supporting patient access
BMS Access Support® may help support patient access by conducting benefits reviews and offering prior authorization and appeals process assistance for enrolled patients. Additionally, the information below provides product-specific billing and diagnosis codes, reimbursement and coding guides, distribution information, and additional coverage support offerings. To view available coding and coverage information, please select your patient’s prescribed medication.
Additional eligibility criteria and terms may apply. Bristol Myers Squibb and its agents make no guarantee regarding reimbursement for any service or item.
Read more about our coverage support offerings
Benefits Reviews
- Once a patient is enrolled in BMS Access Support, we can review their insurance coverage and provide a summary of benefits within approximately 24 hours*
- A benefits review may help determine whether or not a medication is covered, if a PA is required, and estimated patient out-of-pocket costs
*BMS Access Support Data - Benefits review. Accessed August 2022.
Prior Authorization (PA) and Appeals Assistance
- Use the BMS Access Map to identify plan-specific PA requirements
- View our forms and resources page for helpful support tools, including appeals letter templates and medical necessity letters
Annual Reverification
- Reverification of benefits is available upon request to confirm a patient’s benefits for the new year
- Connect with your local Access and Reimbursement Manager for more information
Medication Menu
AUGTYRO™
(repotrectinib)
Indication(s) Important Safety Information U.S. Full Prescribing Information
The accurate completion of reimbursement- or coverage-related documentation is the responsibility of the healthcare provider and patient. Bristol Myers Squibb and its agents make no guarantee regarding reimbursement for any service or item.
Reimbursement and Coding Guide
for AUGTYRO
Additional coverage support offerings
Free Trial Offer
A free trial offer may be available for patients newly prescribed AUGTYRO.
Bridge Program
Has your commercially insured patient experienced a delay in coverage or a coverage denial for AUGTYRO? They may be eligible for a bridge program while they await coverage.
To learn more about the eligibility requirements for the Free Trial offer or Bridge Program, call BMS Access Support at 1-800-861-0048 or reach out to your local Access and Reimbursement Manager for more information.
Restrictions apply. Please see full Terms and Conditions, including complete eligibility requirements.
Filter results by:
National Drug Codes (NDC)1
Issued by the FDA
Note: Payers require the submission of the 11-digit NDC on healthcare claim forms. Please use the 11-digit codes shown here.
| 00003-4040-60 Copy | 40 mg capsules, bottles of 60 capsules |
| 00003-4040-12 Copy | 40 mg capsules, bottles of 120 capsules |
Current Procedural Terminology (CPT)2†
The CPT codes below may be appropriate to use when billing for ROS1 and NTRK testing.
NGS Tests
| 81445 Copy | Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA analysis |
| 81450 Copy | Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA expression levels, if performed; DNA analysis or combined DNA and RNA analysis |
| 81455 Copy | Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mRNA expression levels, if performed; DNA analysis or combined DNA and RNA analysis |
IHC Tests
| 88341 Copy | Immunohistochemistry or immunocytochemistry, each additional single antibody stain procedure (List separately in addition to code for primary procedure) |
| 88342 Copy | Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure |
FISH Tests
| 88364 Copy | In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) |
| 88365 Copy | In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure |
| 88374 Copy | Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure |
| 88377 Copy | Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure |
RT-PCR Test
| 81479 Copy | Unlisted molecular pathology procedure |
International Classification of Diseases, Tenth Revision, Clinical Modification Diagnosis Codes (ICD-10-CM)3
Breast Cancer ICD-10 Codes
| C50 Copy | Malignant neoplasm of breast |
| C50.0 Copy | Malignant neoplasm of nipple and areola |
| C50.01–C50.019 Copy | Malignant neoplasm of nipple and areola, female |
| C50.02–C50.029 Copy | Malignant neoplasm of nipple and areola, male |
| C50.1 Copy | Malignant neoplasm of central portion of breast |
| C50.11–C50.119 Copy | Malignant neoplasm of central portion of breast, female |
| C50.12–C50.129 Copy | Malignant neoplasm of central portion of breast, male |
| C50.2 Copy | Malignant neoplasm of upper-inner quadrant of breast |
| C50.21–C50.219 Copy | Malignant neoplasm of upper-inner quadrant of breast, female |
| C50.22–C50.229 Copy | Malignant neoplasm of upper-inner quadrant of breast, male |
| C50.3 Copy | Malignant neoplasm of lower-inner quadrant of breast |
| C50.31–C50.319 Copy | Malignant neoplasm of lower-inner quadrant of breast, female |
| C50.32–C50.329 Copy | Malignant neoplasm of lower-inner quadrant of breast, male |
| C50.4 Copy | Malignant neoplasm of upper-outer quadrant of breast |
| C50.41–C50.419 Copy | Malignant neoplasm of upper-outer quadrant of breast, female |
| C50.42–C50.429 Copy | Malignant neoplasm of upper-outer quadrant of breast, male |
| C50.5 Copy | Malignant neoplasm of lower-outer quadrant of breast |
| C50.51–C50.519 Copy | Malignant neoplasm of lower-outer quadrant of breast, female |
| C50.52–C50.529 Copy | Malignant neoplasm of lower-outer quadrant of breast, male |
| C50.6 Copy | Malignant neoplasm of axillary tail of breast |
| C50.61–C50.619 Copy | Malignant neoplasm of axillary tail of breast, female |
| C50.62–C50.629 Copy | Malignant neoplasm of axillary tail of breast, male |
| C50.8 Copy | Malignant neoplasm of overlapping sites of breast |
| C50.81–C50.819 Copy | Malignant neoplasm of overlapping sites of breast, female |
| C50.82–C50.829 Copy | Malignant neoplasm of overlapping sites of breast, male |
| C50.9 Copy | Malignant neoplasm of breast of unspecified site |
| C50.91–C50.919 Copy | Malignant neoplasm of breast of unspecified site, female |
| C50.92–C50.929 Copy | Malignant neoplasm of breast of unspecified site, male |
Intrahepatic Bile Duct Carcinoma ICD-10 Codes
| C22.1 Intrahepatic bile duct carcinoma Copy |
Colorectal Cancer ICD-10 Codes
| C18 Copy | Malignant neoplasm of colon |
| C18.0 Copy | Malignant neoplasm of cecum |
| C18.1 Copy | Malignant neoplasm of appendix |
| C18.2 Copy | Malignant neoplasm of ascending colon |
| C18.3 Copy | Malignant neoplasm of hepatic flexure |
| C18.4 Copy | Malignant neoplasm of transverse colon |
| C18.5 Copy | Malignant neoplasm of splenic flexure |
| C18.6 Copy | Malignant neoplasm of descending colon |
| C18.7 Copy | Malignant neoplasm of sigmoid colon |
| C18.8 Copy | Malignant neoplasm of overlapping sites of colon |
| C18.9 Copy | Malignant neoplasm of colon, unspecified |
| C19 Copy | Malignant neoplasm of rectosigmoid junction |
| C20 Copy | Malignant neoplasm of rectum |
| C21.8 Copy | Malignant neoplasm of overlapping sites of rectum, anus and anal canal |
| C48 Copy | Malignant neoplasm of retroperitoneum and peritoneum |
| C48.0 Copy | Malignant neoplasm of retroperitoneum |
| C48.1 Copy | Malignant neoplasm of specified parts of peritoneum |
| C48.2 Copy | Malignant neoplasm of peritoneum, unspecified |
| C48.8 Copy | Malignant neoplasm of overlapping sites of retroperitoneum and peritoneum |
Gynecological Cancer ICD-10 Codes
| C52 Copy | Malignant neoplasm of vagina |
| C53-C53.9 Copy | Malignant neoplasm of cervix uteri |
| C54-C54.9 Copy | Malignant neoplasm of corpus uteri |
| C55 Copy | Malignant neoplasm of uterus, part unspecified |
| C56-C56.9 Copy | Malignant neoplasm of ovary |
| C57 Copy | Malignant neoplasm of other and unspecified female genital organs |
| C57.0 Copy | Malignant neoplasm of fallopian tube |
| C57.00 Copy | Malignant neoplasm of unspecified fallopian tube |
| C57.01 Copy | Malignant neoplasm of right fallopian tube |
| C57.02 Copy | Malignant neoplasm of left fallopian tube |
| C57.7 Copy | Malignant neoplasm of other specified female genital organs |
| C57.8 Copy | Malignant neoplasm of overlapping sites of female genital organs |
| C57.9 Copy | Malignant neoplasm of female genital organ, unspecified |
Neuroendocrine Cancer ICD-10 Codes
| C7A Copy | Malignant neuroendocrine tumors |
| C7A.0 Copy | Malignant carcinoid tumors |
| C7A.00 Copy | Malignant carcinoid tumor of unspecified site |
| C7A.01 Copy | Malignant carcinoid tumors of the small intestine |
| C7A.010 Copy | Malignant carcinoid tumor of the duodenum |
| C7A.011 Copy | Malignant carcinoid tumor of the jejunum |
| C7A.012 Copy | Malignant carcinoid tumor of the ileum |
| C7A.019 Copy | Malignant carcinoid tumor of the small intestine, unspecified portion |
| C7A.02 Copy | Malignant carcinoid tumors of the appendix, large intestine, and rectum |
| C7A.020 Copy | Malignant carcinoid tumor of the appendix |
| C7A.021 Copy | Malignant carcinoid tumor of the cecum |
| C7A.022 Copy | Malignant carcinoid tumor of the ascending colon |
| C7A.023 Copy | Malignant carcinoid tumor of the transverse colon |
| C7A.024 Copy | Malignant carcinoid tumor of the descending colon |
| C7A.025 Copy | Malignant carcinoid tumor of the sigmoid colon |
| C7A.026 Copy | Malignant carcinoid tumor of the rectum |
| C7A.029 Copy | Malignant carcinoid tumor of the large intestine, unspecified portion |
| C7A.09 Copy | Malignant carcinoid tumor of other sites |
| C7A.090 Copy | Malignant carcinoid tumor of the bronchus and lung |
| C7A.091 Copy | Malignant carcinoid tumor of the thymus |
| C7A.092 Copy | Malignant carcinoid tumor of the stomach |
| C7A.093 Copy | Malignant carcinoid tumor of the kidney |
| C7A.094 Copy | Malignant carcinoid tumor of the foregut, unspecified |
| C7A.095 Copy | Malignant carcinoid tumor of the midgut, unspecified |
| C7A.096 Copy | Malignant carcinoid tumor of the hindgut, unspecified |
| C7A.098 Copy | Malignant carcinoid tumor of other sites |
| C7A.1 Copy | Malignant poorly differentiated neuroendocrine tumors |
| C7A.8 Copy | Other malignant neuroendocrine tumors |
Non-small Cell Lung Cancer ICD-10 Codes
| C33 | Malignant neoplasm of trachea |
| C34.0 | Malignant neoplasm of main bronchus |
| C34.00 | Malignant neoplasm of unspecified main bronchus |
| C34.01 | Malignant neoplasm of right main bronchus |
| C34.02 | Malignant neoplasm of left main bronchus |
| C34.1 | Malignant neoplasm of upper lobe, bronchus or lung |
| C34.10 | Malignant neoplasm of upper lobe, unspecified bronchus or lung |
| C34.11 | Malignant neoplasm of upper lobe, right bronchus or lung |
| C34.12 | Malignant neoplasm of upper lobe, left bronchus or lung |
| C34.2 | Malignant neoplasm of middle lobe, bronchus or lung |
| C34.3 | Malignant neoplasm of lower lobe, bronchus or lung |
| C34.30 | Malignant neoplasm of lower lobe, unspecified bronchus or lung |
| C34.31 | Malignant neoplasm of lower lobe, right bronchus or lung |
| C34.32 | Malignant neoplasm of lower lobe, left bronchus or lung |
| C34.8 | Malignant neoplasm of overlapping sites of bronchus and lung |
| C34.80 | Malignant neoplasm of overlapping sites of unspecified bronchus and lung |
| C34.81 | Malignant neoplasm of overlapping sites of right bronchus and lung |
| C34.82 | Malignant neoplasm of overlapping sites of left bronchus and lung |
| C34.9 | Malignant neoplasm of unspecified part of bronchus or lung |
| C34.90 | Malignant neoplasm of unspecified part of unspecified bronchus or lung |
| C34.91 | Malignant neoplasm of unspecified part of right bronchus or lung |
| C34.92 | Malignant neoplasm of unspecified part of left bronchus or lung |
Pancreatic Cancer ICD-10 Codes
| C25-C25.9 Malignant neoplasm of pancreas Copy |
Salivary Gland Cancer ICD-10 Codes
| C07 Copy | Malignant neoplasm of parotid gland |
| C08 Copy | Malignant neoplasm of other and unspecified major salivary glands |
| C08.0 Copy | Malignant neoplasm of submandibular gland |
| C08.1 Copy | Malignant neoplasm of sublingual gland |
| C08.9 Copy | Malignant neoplasm of major salivary gland, unspecified |
Sarcoma ICD-10 Codes
| C47-C47.9 Copy | Malignant neoplasm of peripheral nerves and autonomic nervous system |
| C48-C48.8 Copy | Malignant neoplasm of retroperitoneum and peritoneum |
| C49-C49.9 Copy | Malignant neoplasm of other connective and soft tissue |
| C49.A-C49.A9 Copy | Gastrointestinal stromal tumor |
| C40-C40.92 Copy | Malignant neoplasm of bone and articular cartilage of limbs |
| C41-C41.9 Copy | Malignant neoplasm of bone and articular cartilage of other and unspecified sites |
Thyroid Cancer ICD-10 Codes
| C73 Copy | Malignant neoplasm of thyroid gland |
Melanoma ICD-10 Codes
| C43-C43.9 Copy | Malignant melanoma of skin |
Primary Central Nervous System ICD-10 Codes
| C71 Copy | Malignant neoplasm of brain |
| C71.0 Copy | Malignant neoplasm of cerebrum, except lobes and ventricles |
| C71.1 Copy | Malignant neoplasm of frontal lobe |
| C71.2 Copy | Malignant neoplasm of temporal lobe |
| C71.3 Copy | Malignant neoplasm of parietal lobe |
| C71.4 Copy | Malignant neoplasm of occipital lobe |
| C71.5 Copy | Malignant neoplasm of cerebral ventricle |
| C71.6 Copy | Malignant neoplasm of cerebellum |
| C71.7 Copy | Malignant neoplasm of brain stem |
| C71.8 Copy | Malignant neoplasm of overlapping sites of brain |
| C71.9 Copy | Malignant neoplasm of brain, unspecified |
Hepatocellular Cancer ICD-10 Codes
| C22.0 Copy | Liver cell carcinoma |
Mesothelioma ICD-10 Codes
| C45.0 Copy | Mesothelioma of pleura |
| C45.1 Copy | Mesothelioma of peritoneum |
Coding for AUGTYRO is dependent on the insurer and the care setting in which the drug will be administered. Oncology practices need to make coding decisions based on the diagnosis and treatment of each patient and the specific insurer requirements.
Please see U.S. Full Prescribing Information for AUGTYRO .
The HCP and patient are responsible for the accurate completion of documents regarding reimbursement or coverage. Bristol Myers Squibb and its agents make no guarantee regarding reimbursement for any service or item. This is not a comprehensive list of ICD-10-CM codes.
*Healthcare providers should code healthcare claims based upon the service that is rendered, the patient’s medical record, the coding requirements of each health insurer, and best coding practices. Coding information provided under this heading does not provide a guarantee of reimbursement and should be considered together with all applicable coding guidance and standards. All of the coding information presented by this website is applicable to outpatient procedures only.
†CPT codes and descriptions only are ©2024 by American Medical Association (AMA). All rights reserved. The AMA assumes no liability for data contained or not contained herein. CPT is a registered trademark of the American Medical Association.
References:
- AUGTYRO [package insert]. Princeton, NJ: Bristol-Myers Squibb Company.
- American Medical Association. CPT® 2023 Professional Edition. Chicago, IL: American Medical Association; 2023.
- Centers for Medicare & Medicaid Services. ICD-10-CM tabular list of diseases and injuries. https://www.cms.gov/medicare/coding-billing/icd-10-codes/2024-icd-10-cm. Accessed March 27, 2024.
The following distributors are authorized to sell AUGTYRO and are able to service qualified accounts.
Physician Offices
| Specialty Distributor | Phone Orders | Fax Orders and Website |
|---|---|---|
| Cardinal Health Specialty Pharmaceutical Distribution | 1‑877‑453‑3972 | https://specialtyonline.cardinalhealth.com |
| CuraScript Specialty Distribution | 1‑877‑599‑7748 | https://www.curascriptsd.com |
| McKesson Specialty Health | 1‑800‑482‑6700 | https://mscs.mckesson.com |
| Morris & Dickson Specialty | 1‑800‑710‑6100 | Fax: 1‑318‑524‑3096 https://www.mdspecialtydist.com |
| Oncology Supply | 1‑800‑633‑7555 | https://www.oncologysupply.com |
Hospitals and Infusion Centers
| Specialty Distributor | Phone Orders | Fax Orders and Website |
|---|---|---|
| ASD Healthcare | 1-800‑746‑6273 | Fax: 1‑800‑547‑9413 https://www.asdhealthcare.com |
| Cardinal Health Specialty Pharmaceutical Distribution | 1‑866‑677‑4844 | Fax: 1‑614‑553‑6301 https://orderexpress.cardinalhealth.com |
| McKesson Plasma and Biologics | 1‑877‑625‑2566 | Fax: 1‑888‑752‑7626 https://connect.mckesson.com |
| Morris & Dickson Specialty | 1‑800‑710‑6100 | Fax: 1‑318‑524‑3096 https://www.mdspecialtydist.com |
Puerto Rico Hospitals and Clinics
| Authorized Distributor | Phone Orders | Fax Orders and Website |
|---|---|---|
| Amerisource Bergen Puerto Rico |
1‑844‑222‑2273 | https://abcorder.amerisourcebergen.com |
| Cardinal Puerto Rico (Borschow) | 1‑787‑625‑4200 | https://www.cardinalhealth.pr/ |
| Cesar Castillo, Inc. | 1‑787‑641‑5242 (Hospitals) 1‑787‑641‑5082 (Specialty Pharmacies) |
Fax: 1‑787‑999‑1614 https://www.facilfarmaciacci.com |
Above information is accurate as of 05/24.
AUGTYRO is available through external specialty pharmacies. Please check with your patient's insurance plan for the appropriate specialty pharmacy.
AUGTYRO can also be procured by the practice directly from one of the authorized distributors in the list above. Please ensure your practice has the durable medical equipment (DME) license in place to bill the appropriate DME Medicare Administrative Contractor (DME MAC).
The AUGTYRO distribution program includes extended payment terms to Bristol Myers Squibb authorized AUGTYRO distributors. Healthcare providers and institutions should contact their AUGTYRO distributor to understand specific payment terms that may be available to them from their distributor.
Please see U.S. Full Prescribing Information for AUGTYRO.
FDA Approval Letters as Posted by the FDA:
AUGTYRO for the treatment of adult patients with locally advanced or metastatic ROS1-positive non-small cell lung cancer (NSCLC) – Approved on 11/15/2023
View Letter
AUGTYRO for the treatment of adult and pediatric patients 12 years of age and older with solid tumors that:
- have a neurotrophic tyrosine receptor kinase (NTRK) gene fusion,
- are locally advanced or metastatic or where surgical resection is likely to result in severe morbidity, and
- have progressed following treatment or have no satisfactory alternative therapy – Approved on 06/13/2024
Please see U.S. Full Prescribing Information for AUGTYRO for complete indications.
